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Saiydoun G, Vallée M, Saade S, Colombier C, Nyango Timoh K, de Vries P, Perrenot C, Berte N, Delafontaine A. Accessibility and satisfaction's analysis of simulation-based training in surgery for residents and surgical fellows in France. J Visc Surg 2024:S1878-7886(24)00094-8. [PMID: 39034200 DOI: 10.1016/j.jviscsurg.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
BACKGROUND In surgery, simulated-based training improves the knowledge and interpersonal skills needed for surgeons to improve their performance and meet the "never the first time on a patient" imperative. The objective is to evaluate the effects of a 2017 reform on surgeon's accessibility to simulation-based training, five years after the implementation of the program, and to gauge surgeon satisfaction. METHODS A 27-item national online survey was sent to all surgical residents and fellows in the 13 surgical specialties. RESULTS Among 523 responses, 405 (77.4%) were residents and 118 (22.6%) were surgical fellows. Two hundred forty-seven (47.2%) of surgical residents and fellows stated they did not have a simulation structure or simulation program in the town of their university hospital center. Two hundred thirty-five (44.9%) reported having simulation training programs and 41 (7.8%) reported having easy and free access to their simulation structure. Regarding simulation-based training, 44.6% of surgical residents and fellows had never received training in technical skills on simulators, 82.2% had never received training in teamwork or interprofessional skills and 76.1% had never received training in behavioral or relational skills. There was a significant difference between the degree of satisfaction of residents at the beginning and at the end of the study (P=0.02). CONCLUSION Simulation is a well-established educational tool, but there are still strong inequalities between universities. Despite the national deployment of simulation-based teaching programs and institutional efforts, surgical simulation is insufficiently developed in France, and learner satisfaction is poor.
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Affiliation(s)
- Gabriel Saiydoun
- Department of Cardiac Surgery, University Hospital Pitié Salpetrière, AP-HP, Paris, France; Department of Cardiac Surgery, University Hospital Henri-Mondor, AP-HP, Créteil, France
| | - Maxime Vallée
- Department of Urology, University Hospital of Poitiers, Poitiers, France; Inserm U1070, "pharmacologie des anti-infectieux", pôle biologie santé, UFR médecine-pharmacie, University of Poitiers, bâtiment B36 TSA, 51106 Poitiers, France
| | - Saadé Saade
- Department of Cardiac Surgery, hôpitaux universitaires de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France
| | - Clément Colombier
- Cardiothoracic and vascular surgery Department, University Hospital of Poitiers, Poitiers, France
| | - Krystel Nyango Timoh
- France Inserm, Department of Obstetrics and Gynecology, LTSI - UMR 1099, University Rennes 1, Rennes University Hospital, Rennes, France; Laboratoire d'anatomie et d'organogenèse, faculté de médecine, CHU de Rennes, Rennes, France
| | | | - Cyril Perrenot
- Department of digestive surgery, Robert-Debré Hospital, Reims Hospital, Reims, France
| | - Nicolas Berte
- Department of Pediatric Surgery, University Hospital of Nancy, Nancy, France; Nancy's School of Surgery, University of Lorraine, Virtual Hospital of Lorraine, Nancy, France
| | - Arnaud Delafontaine
- Laboratoire d'anatomie fonctionnelle, faculté des sciences de la motricité, route de Lennik, 808, CP 619, 1070 Bruxelles, Belgium; Laboratoire d'anatomie, de biomécanique et d'organogenèse, faculté de médecine, route de Lennik, 808, CP 619, 1070 Bruxelles, Belgium.
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Savir S, Khan AA, Yunus RA, Gbagornah P, Levy N, Rehman TA, Saeed S, Sharkey A, Jackson CD, Mahmood F, Mitchell J, Matyal R. Virtual Reality Training for Central Venous Catheter Placement: An Interventional Feasibility Study Incorporating Virtual Reality Into a Standard Training Curriculum of Novice Trainees. J Cardiothorac Vasc Anesth 2024:S1053-0770(24)00439-7. [PMID: 39048413 DOI: 10.1053/j.jvca.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 06/24/2024] [Accepted: 07/01/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVES This study assess the feasibility of integrating virtual reality (VR) simulation into the central venous catheter (CVC) placement training curriculum. DESIGN The study consists of 3 parts: (1) Evaluating current manikin-based training for CVC placement through surveys for senior first-year anesthesia residents and cardiac anesthesia faculty who supervise resident performing the procedure; (2) Interventional study training novice trainees with VR simulator and assessing their reaction satisfaction; and (3) pilot study integrating VR training sessions into CVC training curriculum for first-year anesthesia residents. SETTING Conducted at a single academic-affiliated medical center from December 2022 to August 2023. PARTICIPANTS Junior first-year anesthesia residents. INTERVENTIONS VR training sessions for CVC placements using the Vantari VR system. MEASUREMENTS AND MAIN RESULTS Primary outcome: novice trainees' satisfaction with VR training for CVC procedure. Satisfaction of resident and faculty with standard manikin-based training was also collected. Faculty expressed concerns about residents' confidence and perceived knowledge in performing CVC placement independently. Novice trainees showed high satisfaction and perceived usefulness with VR training, particularly in understanding procedural steps and developing spatial awareness. Pilot integration of VR training into the curriculum demonstrated comparable training times and emphasized structured stepwise training modules to ensure completion of vital procedural steps. CONCLUSIONS This study underscores the potential of VR simulation as a complementary training tool for CVC placement rather than a substitution of standard manikin training. VR is offering immersive experiences and addressing limitations of traditional manikin-based training methods. The integration of VR into training curricula warrants further exploration to optimize procedural proficiency and patient safety in clinical practice.
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Affiliation(s)
- Shiri Savir
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA
| | - Adnan A Khan
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA
| | - Rayaan A Yunus
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA
| | - Peva Gbagornah
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA
| | - Nadav Levy
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA
| | - Taha A Rehman
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA
| | - Shirin Saeed
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA
| | - Aidan Sharkey
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA
| | - Cullen D Jackson
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA
| | - Feroze Mahmood
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA
| | - John Mitchell
- Department of Anesthesia, Pain Management and Perioperative Medicine, Henry Ford Health, Detroit, MI
| | - Robina Matyal
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA.
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Zabaleta J, Blasco A, Esnal T, Aguinagalde B, López IJ, Fernandez-Monge A, Lizarbe JA, Báez J, Aldazabal J. Clinical trial on nurse training through virtual reality simulation of an operating room: assessing satisfaction and outcomes. Cir Esp 2024:S2173-5077(24)00117-0. [PMID: 38762218 DOI: 10.1016/j.cireng.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/12/2024] [Indexed: 05/20/2024]
Abstract
INTRODUCTION Virtual reality (VR) provides a firsthand active learning experience through varying degrees of immersion. The aim of this study is to evaluate the use of VR as a potential tool for training operating room nurses to perform thoracic surgery procedures. METHODS This is an open parallel-group randomized clinical trial. One group received basic formation followed by an assessment module. The experimental group received the same basic formation, followed by thoracic surgery training and an assessment module. RESULTS Fifty-six nurses participated in the study (51 females), with a mean age of 41.6 years. Participants achieved a median evaluation mode score of 480 points (IQR = 32 points). The experimental group (520 points) achieved an overall higher score than the control group (440 points; P = .04). Regarding age, women in the second quartile of age among the participants (35-41 years) achieved significantly better results than the rest (P = .04). When we evaluated the results based on the moment of practice, exercises performed in the last 10 min obtained better results than those performed in the first 10 min (1064 points versus 554 points; P < .001). Regarding adverse effects blurred vision was the most frequent. The overall satisfaction rating with the experience was 8.5 out of 10. CONCLUSION Virtual reality is a useful tool for training operating room nurses. Clinical trial with ISRCTN16864726 registered number.
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Affiliation(s)
- Jon Zabaleta
- Department of Thoracic Surgery, Basque Health Service, Donostialdea Integrated Health Organisation, San Sebastian, Spain.
| | - Amaya Blasco
- Department of Thoracic Surgery, Basque Health Service, Donostialdea Integrated Health Organisation, San Sebastian, Spain
| | | | - Borja Aguinagalde
- Department of Thoracic Surgery, Basque Health Service, Donostialdea Integrated Health Organisation, San Sebastian, Spain
| | - Iker J López
- Department of Thoracic Surgery, Basque Health Service, Donostialdea Integrated Health Organisation, San Sebastian, Spain
| | - Arantza Fernandez-Monge
- Department of Thoracic Surgery, Basque Health Service, Donostialdea Integrated Health Organisation, San Sebastian, Spain
| | - Jon A Lizarbe
- Department of Thoracic Surgery, Basque Health Service, Donostialdea Integrated Health Organisation, San Sebastian, Spain
| | - Jaime Báez
- Tecnun, School of Engineering, University of Navarra, San Sebastian, Spain
| | - Javier Aldazabal
- Tecnun, School of Engineering, University of Navarra, San Sebastian, Spain
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Pamplin JC, Veazey SR, Barczak S, Fonda SJ, Serio-Melvin ML, Ross KS, Colombo CJ. Randomized Controlled Trial of Telementoring During Resource-Limited Patient Care Simulation Improves Caregiver Performance and Patient Survival. Crit Care Explor 2024; 6:e1090. [PMID: 38736901 PMCID: PMC11086961 DOI: 10.1097/cce.0000000000001090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
OBJECTIVES To determine the impact of telementoring on caregiver performance during a high-fidelity medical simulation model (HFMSM) of a critically ill patient in a resource-limited setting. DESIGN A two-center, randomized, controlled study using a HFMSM of a patient with community-acquired pneumonia complicated by acute respiratory distress syndrome. SETTING A notional clinic in a remote location staffed by a single clinician and nonmedical assistant. PARTICIPANTS Clinicians with limited experience managing critically ill patients. INTERVENTIONS Telemedicine (TM) support. MEASUREMENTS The primary outcome was clinical performance as measured by accuracy, reliability, and efficiency of care. Secondary outcomes were patient survival, procedural quality, subjective assessment of the HFMSM, and perceived workload. MAIN RESULTS TM participants (N = 11) performed better than non-TM (NTM, N = 12) in providing expected care (accuracy), delivering care more consistently (reliability), and without consistent differences in efficiency (timeliness of care). Accuracy: TM completed 91% and NTM 42% of expected tasks and procedures. Efficiency: groups did not differ in the mean (± sd) minutes it took to obtain an advanced airway successfully (TM 15.2 ± 10.5 vs. NTM 22.8 ± 8.4, p = 0.10) or decompress a tension pneumothorax with a needle (TM 0.7 ± 0.5 vs. NTM 0.6 ± 0.9, p = 0.65). TM was slower than NTM in completing thoracostomy (22.3 ± 10.2 vs. 12.3 ± 4.8, p = 0.03). Reliability: TM performed 13 of 17 (76%) tasks with more consistent timing than NTM. TM completed 68% and NTM 29% of procedural quality metrics. Eighty-two percent of the TM participants versus 17% of the NTM participants simulated patients survived (p = 0.003). The groups similarly perceived the HFMSM as realistic, managed their patients with personal ownership, and experienced comparable workload and stress. CONCLUSIONS Remote expertise provided with TM to caregivers in resource-limited settings improves caregiver performance, quality of care, and potentially real patient survival. HFMSM can be used to study interventions in ways not possible with real patients.
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Affiliation(s)
- Jeremy C Pamplin
- The U.S. Army Telemedicine and Advanced Technology Research Center, Frederick, MD
- Department of Medicine, Department of Emergency and Operational Medicine, The Uniformed Services University, Bethesda, MD
- Department of Emergency and Operational Medicine, The Uniformed Services University, Bethesda, MD
- The U.S. Army Institute of Surgical Research, San Antonio, TX
- The Geneva Foundation, Tacoma, WA
| | - Sena R Veazey
- The U.S. Army Institute of Surgical Research, San Antonio, TX
| | | | | | | | | | - Christopher J Colombo
- Department of Medicine, Department of Emergency and Operational Medicine, The Uniformed Services University, Bethesda, MD
- The U.S. Army Institute of Surgical Research, San Antonio, TX
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Bindayel IA, Alahmad SA. Perception of faculty in the community health sciences colleges towards simulation-based education in clinical nutrition undergraduate practical courses. BMC MEDICAL EDUCATION 2024; 24:402. [PMID: 38605334 PMCID: PMC11007933 DOI: 10.1186/s12909-024-05338-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 03/21/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Simulation now is widely used for training and education in different fields including healthcare education. Medicine and healthcare students can be trained in a secure, efficient, and engaging setting by Simulation-based Education (SBE). Therefore, this study aimed to assess the perception of faculty members in the community health departments towards SBE to be used in practical subjects for clinical nutrition undergraduate courses. METHOD This cross-sectional survey was conducted among community health sciences faculty members. The perception was assessed using a self-administered questionnaire that included three sections. RESULTS This questionnaire was completed by 125 faculty members, of whom 36 (28.8%) were male and 89 (71.2%) were female. Overall, faculty members had positive perceptions, with a mean score of 3.86 ± 0.74, but a high level of anxiety toward SBE, with a mean score of 3.42 ± 0.75. There was a statistically significant difference between the responses of the faculty members based on the training they received in simulation (P = 0.001). CONCLUSION The study results indicate that community health sciences faculty members' perception of SBE in Saudi Arabia is generally positive. However, the results show high levels of anxiety among faculty members toward SBE.
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Affiliation(s)
- Iman Abdullah Bindayel
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
| | - Shahad Ahmed Alahmad
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Eklics K, Csongor A, Hambuch A, Fekete JD. Diverse Integration of Simulated Patients in Medical Education for Communication, Language, and Clinical Skills in Hungary. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2024; 15:301-312. [PMID: 38618523 PMCID: PMC11016270 DOI: 10.2147/amep.s438102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 03/11/2024] [Indexed: 04/16/2024]
Abstract
Medical education and communication training has been undergoing substantial changes recently in our globalized environment. Multidisciplinary simulation-based methods worldwide focus on improving effective clinical skills including history taking, physical examination, diagnostic skills, critical thinking, therapeutic skills, and others via interactions between medical students, trainees, and patients. Recently, Hungary has joined such global trends. The first simulated patient program in Hungary was developed at the University of Pécs Medical School in 2019 to aid effective patient-interviewing skills in language and communication classes. Under the supervision of linguists, communication specialists and medical professionals, the multidisciplinary program uses lay people to perform as simulated patients while using the languages of Hungarian, German, and English. Our simulated patient program plays a specific role in supporting students to learn languages for medical purposes, aiming to prepare them for handling the medical, linguistic, at the same, time emotional and sociocultural difficulties encountered while taking patient histories. Medical and linguistic experts evaluate student performance, provide feedback, and give tailored instruction so that students can advance their communicative and professional skills. This study discusses working formats and the role of constructive feedback exploring potential advantages and disadvantages, sharing ideas, and proposing recommendations on language- and communication-based integration of simulated patients. In our elective communication courses, undergraduate medical students learn to cope with a variety of patient situations through practicing medical emergencies, misunderstandings, and disagreements in a safe atmosphere provided by the MediSkillsLab. Among the benefits, we should emphasize that any course with a growing number of students can be accommodated by carefully designing the program, which allows for interprofessional collaboration. This program contributes to higher-quality medical education, promoting more skilled and compassionate healthcare specialists.
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Affiliation(s)
- Kata Eklics
- Department of Languages for Biomedical Purposes and Communication, Medical School, University of Pécs, Pécs, Hungary
| | - Alexandra Csongor
- Department of Languages for Biomedical Purposes and Communication, Medical School, University of Pécs, Pécs, Hungary
| | - Anikó Hambuch
- Department of Languages for Biomedical Purposes and Communication, Medical School, University of Pécs, Pécs, Hungary
| | - Judit Diana Fekete
- Department of Languages for Biomedical Purposes and Communication, Medical School, University of Pécs, Pécs, Hungary
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Sahi N, Humphrey-Murto S, Brennan EE, O'Brien M, Hall AK. Current use of simulation for EPA assessment in emergency medicine. CAN J EMERG MED 2024; 26:179-187. [PMID: 38374281 DOI: 10.1007/s43678-024-00649-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 01/12/2024] [Indexed: 02/21/2024]
Abstract
OBJECTIVE Approximately five years ago, the Royal College emergency medicine programs in Canada implemented a competency-based paradigm and introduced the use of Entrustable Professional Activities (EPAs) for assessment of units of professional activity to assess trainees. Many competency-based medical education (CBME) based curricula, involve assessing for entrustment through observations of EPAs. While EPAs are frequently assessed in clinical settings, simulation is also used. This study aimed to characterize the use of simulation for EPA assessment. METHODS A study interview guide was jointly developed by all study authors and followed best practices for survey development. A national interview was conducted with program directors or assistant program directors across all the Royal College emergency medicine programs across Canada. Interviews were conducted over Microsoft Teams, interviews were recorded and transcribed, using Microsoft Teams transcribing service. Sample transcripts were analyzed for theme development. Themes were then reviewed by co-authors to ensure they were representative of the participants' views. RESULTS A 64.7% response rate was achieved. Simulation has been widely adopted by EM training programs. All interviewees demonstrated support for the use of simulation for EPA assessment for many reasons, however, PDs acknowledged limitations and thematic analysis revealed certain themes and tensions for using simulation for EPA assessment. Thematic analysis revealed six major themes: widespread support for the use of simulation for EPA assessment, concerns regarding the potential for EPA assessment to become a "tick- box" exercise, logistical barriers limiting the use of simulation for EPA assessment, varied perceptions about the authenticity of using simulation for EPA assessment, the potential for simulation for EPA assessment to compromise learner psychological safety, and suggestions for the optimization of use of simulation for EPA assessment. CONCLUSIONS Our findings offer insight for other programs and specialties on how simulation for EPA assessment can best be utilized. Programs should use these findings when considering using simulation for EPA assessment.
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Affiliation(s)
- Nidhi Sahi
- Department of Innovation in Medical Education (DIME), University of Ottawa, Ottawa, ON, Canada.
| | - Susan Humphrey-Murto
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
- Tier 2 Research Chair in Medical Education and Fellowship Director, Medical Education Research, University of Ottawa, Ottawa, ON, Canada
| | - Erin E Brennan
- Department of Emergency Medicine, Queen's University, Kingston, ON, Canada
| | - Michael O'Brien
- Emergency Medicine, The Ottawa Hospital, Ottawa, ON, Canada
- Department of Innovation in Medical Education, University of Ottawa, Ottawa, ON, Canada
| | - Andrew K Hall
- Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
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Leiphrakpam PD, Armijo PR, Are C. Incorporation of Simulation in Graduate Medical Education: Historical Perspectives, Current Status, and Future Directions. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205241257329. [PMID: 38808125 PMCID: PMC11131395 DOI: 10.1177/23821205241257329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 05/09/2024] [Indexed: 05/30/2024]
Abstract
Technological advancement and improved training strategies have transformed the healthcare practice environment in the last few decades. Simulation has evolved as one of the leading training models for the next generation of healthcare professionals. Simulation-based training enables healthcare professionals to acquire knowledge and skills in a safe and educationally oriented environment and can be a valuable tool for improving clinical practice and patient outcomes. The field of healthcare simulation has been rapidly growing, and various graduate medical education programs around the world have started incorporating this modality into their curricula. In graduate medical education, simulation-based training helps implement an outcome-based curriculum that tests the trainee's actual skill level as the primary factor for the trainee's competency rather than relying on the current model of a predetermined training period. However, the major challenge revolves around developing an educational curriculum incorporating a simulation-based educational model, understanding the value of this new technology, the overall cost factor, and the lack of adequate infrastructure. Hence, embracing the full potential of simulation technology in graduate medical education curricula requires an innovative approach with participation from institutions and stakeholders.
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Affiliation(s)
- Premila D. Leiphrakpam
- Graduate Medical Education, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
- Division of Surgical Oncology, Department of Surgery, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Priscila R. Armijo
- iEXCEL, Academic Affairs, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Chandrakanth Are
- Graduate Medical Education, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
- Division of Surgical Oncology, Department of Surgery, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Gong AT, Yau SWO, Erickson HB, Toepfer RJ, Zhang J, Deschmidt AM, Parsey CJ, Norfleet JE, Sweet RM. Characterizing the Suture Pullout Force for Human Small Bowel. J Biomech Eng 2024; 146:014502. [PMID: 37916891 DOI: 10.1115/1.4063951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 09/25/2023] [Indexed: 11/03/2023]
Abstract
Performing a small bowel anastomosis, or reconnecting small bowel segments, remains a core competency and critical step for the successful surgical management of numerous bowel and urinary conditions. As surgical education and technology moves toward improving patient outcomes through automation and increasing training opportunities, a detailed characterization of the interventional biomechanical properties of the human bowel is important. This is especially true due to the prevalence of anastomotic leakage as a frequent (3.02%) postoperative complication of small bowel anastomoses. This study aims to characterize the forces required for a suture to tear through human small bowel (suture pullout force, SPOF), while analyzing how these forces are affected by tissue orientation, suture material, suture size, and donor demographics. 803 tests were performed on 35 human small bowel specimens. A uni-axial test frame was used to tension sutures looped through 10 × 20 mm rectangular bowel samples to tissue failure. The mean SPOF of the small bowel was 4.62±1.40 N. We found no significant effect of tissue orientation (p = 0.083), suture material (p = 0.681), suture size (p = 0.131), age (p = 0.158), sex (p = .083), or body mass index (BMI) (p = 0.100) on SPOF. To our knowledge, this is the first study reporting human small bowel SPOF. Little research has been published about procedure-specific data on human small bowel. Filling this gap in research will inform the design of more accurate human bowel synthetic models and provide an accurate baseline for training and clinical applications.
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Affiliation(s)
- Alex T Gong
- Department of Surgery, University of Washington, 1959 NE Pacific Ave, Magnuson Health Sciences T293, Seattle, WA 98195-0000
| | - Shi-Wen Olivia Yau
- Department of Surgery, University of Washington, 1959 NE Pacific Ave Magnuson Health Sciences T293, Seattle, WA 98195-0000; Department of Human Centered Design and Engineering, University of Washington, 3960 Benton Ln NE #428, Seattle, WA 98195-0000
| | - Hans B Erickson
- Department of Surgery, University of Washington, 1959 NE Pacific Ave, Magnuson Health Sciences T293, Seattle, WA 98195-0000; Department of Mechanical Engineering, University of Washington, 371 Loew Hall, Seattle, WA 98195-0000
| | - Rudolph J Toepfer
- Department of Surgery, University of Washington, 1959 NE Pacific Ave, Magnuson Health Sciences T293, Seattle, WA 98195-0000; Department of Materials Science and Engineering, University of Washington, 302 Roberts Hall, Seattle, WA 98195-2120
| | - Jessica Zhang
- Department of Surgery, University of Washington, 1959 NE Pacific Ave, Magnuson Health Sciences T293, Seattle, WA 98195-0000; Department of Biochemistry, University of Washington, 1959 NE Pacific Ave, Magnuson Health Sciences J405, Seattle, WA 98195-0000
| | - Aleah M Deschmidt
- Benaroya Research Institute at Virginia Mason, 1201 Ninth Ave, Seattle, WA 98101
| | - Conner J Parsey
- Medical Simulation Research Branch Simulation and Training Technology Center, U.S. Army DEVCOM Soldier Center, 12423 Research Parkway, Orlando, FL 32826
| | - Jack E Norfleet
- Medical Simulation Research Branch Simulation and Training Technology Center, U.S. Army DEVCOM Soldier Center, 12423 Research Parkway, Orlando, FL 32826
| | - Robert M Sweet
- Department of Surgery, University of Washington, 1959 NE Pacific Ave, Magnuson Health Sciences T293, Seattle, WA 98195-0000; Department of Urology, University of Washington, 1959 NE Pacific Ave, Magnuson Health Sciences T293, Seattle, WA 98195-0000; Department of Bioengineering, University of Washington, 3720 15th Ave NE, Seattle, WA 98195-0000
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Wanderling C, Saxton A, Phan D, Sheppard L, Schuler N, Ghazi A. Recent Advances in Surgical Simulation For Resident Education. Curr Urol Rep 2023; 24:491-502. [PMID: 37736826 DOI: 10.1007/s11934-023-01178-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2023] [Indexed: 09/23/2023]
Abstract
PURPOSE OF REVIEW Surgical simulation has become a cornerstone for the training of surgical residents, especially for urology residents. Urology as a specialty bolsters a diverse range of procedures requiring a variety of technical skills ranging from open and robotic surgery to endoscopic procedures. While hands-on supervised training on patients still remains the foundation of residency training and education, it may not be sufficient to achieve proficiency for graduation even if case minimums are achieved. It has been well-established that simulation-based education (SBE) can supplement residency training and achieve the required proficiency benchmarks. RECENT FINDINGS Low-fidelity modules, such as benchtop suture kits or laparoscopic boxes, can establish a strong basic skills foundation. Eventually, residents progress to high-fidelity models to refine application of technical skills and improve operative performance. Human cadavers and animal models remain the gold standard for procedural SBE. Recently, given the well-recognized financial and ethical costs associated with cadaveric and animal models, residency programs have shifted their investments toward virtual and more immersive simulations. Urology as a field has pushed the boundaries of SBE and has reached a level where unexplored modalities, e.g., 3D printing, augmented reality, and polymer casting, are widely utilized for surgical training as well as preparation for challenging cases at both the residents, attending and team training level.
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Affiliation(s)
| | - Aaron Saxton
- Brady Urological Institute, John's Hopkins University, Baltimore, MD, USA
| | - Dennis Phan
- Brady Urological Institute, John's Hopkins University, Baltimore, MD, USA
| | - Lauren Sheppard
- Brady Urological Institute, John's Hopkins University, Baltimore, MD, USA
| | - Nathan Schuler
- Brady Urological Institute, John's Hopkins University, Baltimore, MD, USA
| | - Ahmed Ghazi
- Brady Urological Institute, John's Hopkins University, Baltimore, MD, USA.
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Lipton LB, Vuong L, Nichols AA. Virtual simulated patient encounters: Bridging the gap in maternal mental health training for prelicensure nursing students. J Prof Nurs 2023; 48:22-24. [PMID: 37775236 DOI: 10.1016/j.profnurs.2023.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 05/12/2023] [Accepted: 05/15/2023] [Indexed: 10/01/2023]
Abstract
Postpartum mood disorders (PPMDs) can result in significant negative impacts for the mother, baby, and family. Nurses can be trained to effectively screen for and educate patients about PPMDs. However, available data suggest that clinical opportunities for practicing these important conversations in real-time can be limited. Focused practice discussing PPMDs with patients may improve a nurse's confidence to conduct screenings and help reduce stigma regarding PPMDs. When in-person clinical learning opportunities are limited, simulated patient encounters can serve as useful and accessible alternatives. Though traditional simulations are often conducted in-person with an actor, they can also be offered to students via a virtual platform. This article describes the creation of two virtual simulated patient encounters (vSPEs) designed to improve prelicensure nursing students' confidence in screening and caring for patients at risk for PPMDs. These vSPEs were implemented during the COVID-19 pandemic to fulfill required labor and birth/postpartum clinical rotation hours. A thorough description of the vSPE design and implementation is provided to encourage nursing and other health professions educators to explore a virtual approach to training students to screen and care for postpartum patients with suspected PPMDs.
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Affiliation(s)
- Lisa B Lipton
- Betty Irene Moore School of Nursing at the University of California, Davis, 4610 X St., Sacramento, CA 95817, United States of America
| | - Linda Vuong
- Betty Irene Moore School of Nursing at the University of California, Davis, 4610 X St., Sacramento, CA 95817, United States of America
| | - Amy A Nichols
- Betty Irene Moore School of Nursing at the University of California, Davis, 4610 X St., Sacramento, CA 95817, United States of America.
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Ballit A, Hivert M, Rubod C, Dao TT. Fast soft-tissue deformations coupled with mixed reality toward the next-generation childbirth training simulator. Med Biol Eng Comput 2023:10.1007/s11517-023-02864-5. [PMID: 37382859 DOI: 10.1007/s11517-023-02864-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 06/07/2023] [Indexed: 06/30/2023]
Abstract
High-quality gynecologist and midwife training is particularly relevant to limit medical complications and reduce maternal and fetal morbimortalities. Physical and virtual training simulators have been developed. However, physical simulators offer a simplified model and limited visualization of the childbirth process, while virtual simulators still lack a realistic interactive system and are generally limited to imposed predefined gestures. Objective performance assessment based on the simulation numerical outcomes is still not at hand. In the present work, we developed a virtual childbirth simulator based on the Mixed-Reality (MR) technology coupled with HyperMSM (Hyperelastic Mass-Spring Model) formulation for real-time soft-tissue deformations, providing intuitive user interaction with the virtual physical model and a quantitative assessment to enhance the trainee's gestures. Microsoft HoloLens 2 was used and the MR simulator was developed including a complete holographic obstetric model. A maternal pelvis system model of a pregnant woman (including the pelvis bone, the pelvic floor muscles, the birth canal, the uterus, and the fetus) was generated, and HyperMSM formulation was applied to simulate the soft tissue deformations. To induce realistic reactions to free gestures, the virtual replicas of the user's detected hands were introduced into the physical simulation and were associated with a contact model between the hands and the HyperMSM models. The gesture of pulling any part of the virtual models with two hands was also implemented. Two labor scenarios were implemented within the MR childbirth simulator: physiological labor and forceps-assisted labor. A scoring system for the performance assessment was included based on real-time biofeedback. As results, our developed MR simulation application was developed in real-time with a refresh rate of 30-50 FPS on the HoloLens device. HyperMSM model was validated using FE outcomes: high correlation coefficients of [0.97-0.99] and weighted root mean square relative errors of 9.8% and 8.3% were obtained for the soft tissue displacement and energy density respectively. Experimental tests showed that the implemented free-user interaction system allows to apply the correct maneuvers (in particular the "Viennese" maneuvers) during the labor process, and is capable to induce a truthful reaction of the model. Obtained results confirm also the possibility of using our simulation's outcomes to objectively evaluate the trainee's performance with a reduction of 39% for the perineal strain energy density and 5.6 mm for the vertical vaginal diameter when the "Viennese" technique is applied. This present study provides, for the first time, an interactive childbirth simulator with an MR immersive experience with direct free-hand interaction, real-time soft-tissue deformation feedback, and an objective performance assessment based on numerical outcomes. This offers a new perspective for enhancing next-generation training-based obstetric teaching. The used models of the maternal pelvic system and the fetus will be enhanced, and more delivery scenarios (e.g. instrumental delivery, breech delivery, shoulder dystocia) will be designed and integrated. The third stage of labor will be also investigated to include the delivery of the placenta, and the clamping and cutting of the umbilical cord.
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Affiliation(s)
- Abbass Ballit
- Univ. Lille, CNRS, Centrale Lille, UMR 9013-LaMcube-Laboratoire de Mécanique, Multiphysique, Multiéchelle, Lille, F-59000, France
| | - Mathieu Hivert
- Université Lille Nord de France, Faculté de Médecine, F-59000, Lille, France
- CHU Lille, Service de Chirurgie Gynécologique, F-59000, Lille, France
| | - Chrystèle Rubod
- Univ. Lille, CNRS, Centrale Lille, UMR 9013-LaMcube-Laboratoire de Mécanique, Multiphysique, Multiéchelle, Lille, F-59000, France
- Université Lille Nord de France, Faculté de Médecine, F-59000, Lille, France
- CHU Lille, Service de Chirurgie Gynécologique, F-59000, Lille, France
| | - Tien-Tuan Dao
- Univ. Lille, CNRS, Centrale Lille, UMR 9013-LaMcube-Laboratoire de Mécanique, Multiphysique, Multiéchelle, Lille, F-59000, France.
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13
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Stan C, Vesa D, Tănase MI, Bulmaci M, Pop S, Rădeanu DG, Cosgarea M, Maniu A. Can Non-Virtual Reality Simulation Improve Surgical Training in Endoscopic Sinus Surgery? A Literature Review. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2023; 14:637-646. [PMID: 37360838 PMCID: PMC10290466 DOI: 10.2147/amep.s406537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/07/2023] [Indexed: 06/28/2023]
Abstract
Simulation in endoscopic sinus surgery allows residents to learn anatomy, to achieve the correct handling of various rhinological instruments, and to practice different surgical procedures. Physically or non-virtual reality models are the main items in endoscopic sinus surgery simulation. The objective of this review is to identify and make a descriptive analysis of non-virtual endoscopic sinus surgery simulators which have been proposed for training. As a new state of the art, surgical simulators are developed continuously, so they can be used to learn basic endoscopic surgery skills by repetitive maneuvers, permitting detection of surgical error and incidents without risk for the patient. Of all training physical models, the ovine model stands out because of the similarities of the sinonasal pathways, the wide availability, and the low costs. Considering the similar nature of the tissues involved, the techniques and surgical instruments can be used almost interchangeably with minimal differences. Every surgical technique studied until now has a degree of risk and the only aspects that consistently reduced the number of complications are training, repetition, and hands-on experience.
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Affiliation(s)
- Constantin Stan
- Department of ENT, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, România
- Department of Surgical Clinical, “Dunărea de Jos” University, Faculty of Medicine and Pharmacy, Galați, România
| | - Doiniţa Vesa
- Department of Surgical Clinical, “Dunărea de Jos” University, Faculty of Medicine and Pharmacy, Galați, România
| | - Mihai Ionuț Tănase
- Department of ENT, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, România
| | - Mara Bulmaci
- Department of ENT, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, România
| | - Sever Pop
- Department of ENT, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, România
| | - Doinel Gheorghe Rădeanu
- Department of ENT, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, România
| | - Marcel Cosgarea
- Department of ENT, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, România
| | - Alma Maniu
- Department of ENT, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, România
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Harvey SB, Bezzina AJ, Mac Partlin M, Caldwell J, Short L. 3D-printed procedural task trainer for the aspiration of penile corpus cavernosa in ischaemic priapism. Emerg Med Australas 2023; 35:319-324. [PMID: 36351564 DOI: 10.1111/1742-6723.14131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/22/2022] [Accepted: 10/17/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The development and initial clinical assessment of a novel 3D-printed procedural task trainer for the aspiration of penile corpus cavernosa in ischaemic priapism. METHODS A task trainer for the aspiration of penile corpus cavernosa was designed and manufactured using commercially available 3D printing equipment. The trainer was assessed in two separate training sessions led by faculty investigators. Participants in the sessions were asked to complete a post-procedure survey with regards to the utility and realism of the task trainer. RESULTS The participants (n = 14) covered a broad spectrum of clinician types. The trainer was perceived by the participants as being anatomically realistic, and especially while under drapes provided a reasonable facsimile of real clinical setup. The trainer proved resilient to multiple attempts at aspiration by multiple participants. CONCLUSIONS Participant and facilitator feedback indicates that the task trainer is a useful platform to train for what is a low frequency, but high stakes, procedure. Small numbers of participants preclude statistical rigour and certainty regarding overall performance of the trainer. However, the uniformity in the responses would suggest that this is indeed a task trainer that is 'fit for purpose'.
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Affiliation(s)
- Steven B Harvey
- Medical Imaging Department, Wollongong Hospital, Wollongong, New South Wales, Australia
- Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Andrew J Bezzina
- Illawarra Shoalhaven Health Education Centre, Wollongong Hospital, Wollongong, New South Wales, Australia
| | - Matthew Mac Partlin
- Intensive Care Unit, Wollongong Hospital, Wollongong, New South Wales, Australia
| | - Janice Caldwell
- Illawarra Shoalhaven Health Education Centre, Wollongong Hospital, Wollongong, New South Wales, Australia
| | - Leah Short
- Illawarra Shoalhaven Health Education Centre, Wollongong Hospital, Wollongong, New South Wales, Australia
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Wong K, Gorthey S, Arrighi-Allisan AE, Fan CJ, Barber SR, Schwam ZG, Wanna GB, Cosetti MK. Defining the Learning Curve for Endoscopic Ear Skills Using a Modular Trainer: A Multi-Institutional Study. Otol Neurotol 2023; 44:346-352. [PMID: 36805421 DOI: 10.1097/mao.0000000000003826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
OBJECTIVE Quantify the learning curve for endoscopic ear skills acquisition in otolaryngology residents using a simulator. The secondary objective was to determine if demographic factors or previous endoscopic experience influenced skill development. STUDY DESIGN Prospective, multicenter study. Resident participants each completed 10 amassed trials using a validated endoscopic ear skill trainer. SETTING Two academic teaching hospitals. SUBJECTS Otolaryngology residents. MAIN OUTCOME MEASURES Trial completion times; rate of improvement over time. RESULTS Thirty-eight residents completed the study, 26 from program A and 12 from program B. Fifteen participants were women and 23 were men. Mean age was 30 years old (range 26 to 34 years). Previous experience with otoendoscopy (B = -16.7, p = 0.005) and sinus endoscopy (B = -23.4, p = 0.001) independently correlated with lower overall trial times. Age, gender, postgraduate year, handedness, interest in otology, and video gaming were not associated with trial times. On multivariate logistic regression, resident completion times improved with trial number, and residents without previous endoscopy experience improved at a faster rate than those with experience ( p < 0.001). CONCLUSIONS Novice surgeons may acquire basic endoscopic ear experience with self-directed simulation training. The learning curve for transcanal endoscopic ear surgery is comparable to those demonstrated for other otologic surgeries, and specific task competencies can be achieved within 10 trials, suggesting that previous experiences, or lack thereof, may not dictate the ability to acquire new skills. There may be a translational value to previous endoscopic sinus experience on learning transcanal endoscopic ear surgery.
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Affiliation(s)
| | - Scott Gorthey
- Department of Otolaryngology, Albert Einstein College of Medicine, New York, NY
| | | | | | - Samuel R Barber
- Department of Otolaryngology, University of Arizona College of Medicine, Tucson, AZ
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Kshetrapal A, McBride ME, Mannarino C. Taking the Pulse of the Current State of Simulation. Crit Care Clin 2023; 39:373-384. [PMID: 36898780 DOI: 10.1016/j.ccc.2022.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Simulation in health-care professions has grown in the last few decades. We provide an overview of the history of simulation in other fields, the trajectory of simulation in health professions education, and research in medical education, including the learning theories and tools to assess and evaluate simulation programs. We also propose future directions for simulation and research in health professions education.
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Affiliation(s)
- Anisha Kshetrapal
- Department of Pediatrics, Division of Emergency Medicine, Ann & Robert H Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Box 62, Chicago, IL 60611, USA.
| | - Mary E McBride
- Depatment of Pediatrics, Divisions of Cardiology and Critical Care Medicine, Ann & Robert H Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Box 62, Chicago, IL 60611, USA
| | - Candace Mannarino
- Depatment of Pediatrics, Divisions of Cardiology and Critical Care Medicine, Ann & Robert H Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Box 62, Chicago, IL 60611, USA
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17
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Sansregret A, Garber A, Freire-Lizama T, Monton L, Mueller V, Papalia N, Ruiter PJA, Shore EM, Suri M. Consensus Statement No. 434: Simulation in Obstetrics and Gynaecology. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2023; 45:214-226.e1. [PMID: 37055148 DOI: 10.1016/j.jogc.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
OBJECTIVE To provide a comprehensive and current overview of the evidence for the value of simulation for education, team training, patient safety, and quality improvement in obstetrics and gynaecology, to familiarize readers with principles to consider in developing a simulation program, and to provide tools and references for simulation advocates. TARGET POPULATION Providers working to improve health care for Canadian women and their families; patients and their families. OUTCOMES Simulation has been validated in the literature as contributing to positive outcomes in achieving learning objectives, maintaining individual and team competence, and enhancing patient safety. Simulation is a well-developed modality with established principles to maximize its utility and create a safe environment for simulation participants. Simulation is most effective when it involves interprofessional collaboration, institutional support, and regular repetition. BENEFITS, HARMS, AND COSTS This modality improves teamwork skills, patient outcomes, and health care spending. Upholding prescribed principles of psychological safety when implementing a simulation program minimizes harm to participants. However, simulation can be an expensive tool requiring human resources, equipment, and time. EVIDENCE Articles published between 2003 and 2022 were retrieved through searches of Medline and PubMed using the keywords "simulation" and "simulator." The search was limited to articles published in English and French. The articles were reviewed for their quality, relevance, and value by the SOGC Simulation Working Group. Expert opinion from relevant seminal books was also considered. VALIDATION METHODS The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and conditional [weak] recommendations). INTENDED AUDIENCE All health care professionals working to improve Canadian women's health, and relevant stakeholders, including granting agencies, physician/nursing/midwifery colleges, accreditation bodies, academic centres, hospitals, and training programs. RECOMMENDATIONS
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18
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Sansregret A, Garber A, Freire-Lizama T, Monton L, Mueller V, Papalia N, Ruiter PJA, Shore EM, Suri M. Déclaration de consensus n o 434 : Simulation en obstétrique et gynécologie. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2023; 45:227-240.e1. [PMID: 37055149 DOI: 10.1016/j.jogc.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
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19
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Stockert B, Silberman N, Rucker J, Bradford J, Gorman SL, Greenwood KC, Macauley K, Nordon-Craft A, Quiben M. Simulation-Based Education in Physical Therapist Professional Education: A Scoping Review. Phys Ther 2022; 102:pzac133. [PMID: 36200401 DOI: 10.1093/ptj/pzac133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 06/16/2022] [Accepted: 08/07/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The purposes of this study were to (1) describe and summarize the use of simulation-based education (SBE) with student physical therapists in the international literature and (2) describe the application and integration of standards of best practice (SOBP) for SBE reported in published physical therapy education research. METHODS Ovid MEDLINE, CINAHL, Web of Science, and ERIC databases were searched. The search included any published study that involved the use of SBE with student physical therapists. Because this was a scoping review, only descriptive statistics were compiled; no methodological quality assessment was performed. RESULTS This scoping review revealed a significant increase in literature describing SBE with student physical therapists in the past 10 years. Simulation was used to address learning objectives across a variety of content areas and clinical settings. Communication skills were the most common objectives for simulation. Limited use of SOBP, published in 2016, was reported, and use of author-generated outcome measures without validation was common. CONCLUSIONS Although there has been an increase in literature reporting the use of SBE with student physical therapists across many practice areas and settings, many articles reported limited use and integration of published SOBP and frequently utilized outcome measures that had not been validated. IMPACT The findings show that limited use of validated outcome measures and SOBP constrain the capacity for reproducing studies, comparing findings among studies, and completing systematic reviews that could inform and optimize best practices for the use of SBE in physical therapist professional education. Further research on SBE in physical therapy would benefit from investigations that integrated and reported the use of SOBP for standardized patients, simulation design, and delivery and assessment of learning outcomes over time at multiple Kirkpatrick learning levels.
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Affiliation(s)
- Brad Stockert
- California State University, Department of Physical Therapy, Sacramento, California, USA
| | - Nicki Silberman
- Hunter College, Department of Physical Therapy, New York, New York, USA
| | - Jason Rucker
- University of Kansas Medical Center, Department of Physical Therapy, Rehabilitation Science and Athletic Training, Kansas City, Kansas, USA
| | - Jacque Bradford
- University of Tennessee Health Science Center, College of Health Professions, Department of Physical Therapy, Memphis, Tennessee, USA
| | - Sharon L Gorman
- Samuel Merritt University, Department of Physical Therapy, Oakland, California, USA
| | - Kristin Curry Greenwood
- Bouve College of Health Sciences; Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, Boston, Massachusetts, USA
| | - Kelly Macauley
- College of Health and Pharmacy, Husson University, Bangor, Maine, USA
| | - Amy Nordon-Craft
- University of Colorado, Denver, Anschutz Medical Campus, Physical Therapy Program, Aurora, Colorado, USA
| | - Myla Quiben
- University of North Texas Health Science Center, Department of Physical Therapy, Fort Worth, Texas, USA
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Kane D, Ryan G, Mangina E, McAuliffe F. A randomized control trial of a virtual reality learning environment in obstetric medical student teaching. Int J Med Inform 2022; 168:104899. [DOI: 10.1016/j.ijmedinf.2022.104899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 10/12/2022] [Indexed: 11/05/2022]
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21
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DeSchmidt AM, Gong AT, Batista JE, Song AY, Bidinger SL, Schul AL, Wang EY, Norfleet JE, Sweet RM. Characterization of Puncture Forces of the Human Trachea and Cricothyroid Membrane. J Biomech Eng 2022; 144:1140296. [PMID: 35445243 DOI: 10.1115/1.4054380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Indexed: 12/12/2022]
Abstract
Accurate human tissue biomechanical data represents a critical knowledge gap that will help facilitate the advancement of new medical devices, patient-specific predictive models, and training simulators. Tissues related to the human airway are a top priority, as airway medical procedures are common and critical. Placement of a surgical airway, though less common, is often done in an emergent (cricothyrotomy) or urgent (tracheotomy) fashion. This study is the first to report relevant puncture force data for the human cricothyroid membrane and tracheal annular ligaments. Puncture forces of the cricothyroid membrane and tracheal annular ligaments were collected from 39 and 42 excised human donor tracheas, respectively, with a mechanized load frame holding various surgical tools. The average puncture force of the cricothyroid membrane using an 11 blade scalpel was 1.01 ± 0.36 N, and the average puncture force of the tracheal annular ligaments using a 16 gauge needle was 0.98 ± 0.34 N. This data can be used to inform medical device and airway training simulator development as puncture data of these anatomies has not been previously reported.
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Affiliation(s)
- Aleah M DeSchmidt
- Department of Surgery, University of Washington, 1959 NE Pacific Ave Magnuson Health Sciences T293, Seattle, WA 98195-0000; Department of Bioengineering, University of Washington, 1959 NE Pacific Ave Magnuson Health Sciences T293, Seattle, WA 98195-0000
| | - Alex T Gong
- Department of Surgery, University of Washington, 1959 NE Pacific Ave Magnuson Health Sciences T293, Seattle, WA 98195-0000
| | | | - Agnes Y Song
- Department of Surgery, University of Washington, 1959 NE Pacific Ave Magnuson Health Sciences T293, Seattle, WA 98195-0000; Department of Bioengineering, University of Washington, 1959 NE Pacific Ave Magnuson Health Sciences T293, Seattle, WA 98195-0000
| | - Sophia L Bidinger
- Electrical Engineering Division, University of Cambridge, 9 JJ Thomson Avenue, Cambridge CB3 0FA, UK
| | - Alyssa L Schul
- Philips Healthcare, 22100 Bothell Everett Hwy, Bothell, WA 98021
| | - Everet Y Wang
- Department of Surgery, University of Washington, 1959 NE Pacific Ave Magnuson Health Sciences T293, Seattle, WA 98195-0000
| | - Jack E Norfleet
- Medical Simulation Research Branch Simulation and Training Technology Center, U.S. Army CCDC Soldier Center, 12423 Research Parkway, Orlando, FL 32826
| | - Robert M Sweet
- Department of Surgery, University of Washington, 1959 NE Pacific Ave Magnuson Health Sciences T293, Seattle, WA 98195-0000; Department of Urology, University of Washington, 1959 NE Pacific Ave Magnuson Health Sciences T293, Seattle, WA 98195-0000;Department of Bioengineering, University of Washington, 1959 NE Pacific Ave Magnuson Health Sciences T293, Seattle, WA 98195-0000
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22
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Korayem GB, Alshaya OA, Kurdi SM, Alnajjar LI, Badr AF, Alfahed A, Cluntun A. Simulation-Based Education Implementation in Pharmacy Curriculum: A Review of the Current Status. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2022; 13:649-660. [PMID: 35801134 PMCID: PMC9255713 DOI: 10.2147/amep.s366724] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/20/2022] [Indexed: 05/31/2023]
Abstract
Simulation-based education (SBE) is a fundamental teaching method that complements traditional teaching modalities. SBE has improved students' knowledge, understanding, and numerous essential skills within undergraduate pharmacy education, similar to traditional teaching methods. However, SBE has become crucial for developing students' teamwork, decision-making, and communication skills. Even though the Accreditation Council for Pharmacy Education (ACPE) has acknowledged the benefit of SBE in interprofessional education (IPE) and the introductory pharmacy practice experience (IPPE). This article provides evidence that SBE can be effective beyond that. This narrative review is focused on the literature related to SBE modalities and the assessment methods of student learning outcomes in the undergraduate pharmacy curriculum. The review illustrates that SBE is an effective teaching method that could be utilized within the pharmacy curriculum. The review also could help pharmacy educators decide on the best modality and placement of integrating patient simulation within the pharmacy curriculum. Combining multiple simulation techniques may be the best way to achieve the desired student learning outcomes.
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Affiliation(s)
- Ghazwa B Korayem
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Omar A Alshaya
- Department of Pharmacy Practice, College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Pharmaceutical Care Services, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Sawsan M Kurdi
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Lina I Alnajjar
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Aisha F Badr
- Pharmacy Practice Department, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Amjaad Alfahed
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Ameera Cluntun
- Curriculum and Training Department, Health Academy, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
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23
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A Novel Method of Exploring the Uncanny Valley in Avatar Gender(Sex) and Realism Using Electromyography. BIG DATA AND COGNITIVE COMPUTING 2022. [DOI: 10.3390/bdcc6020061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Despite the variety of applications that use avatars (virtual humans), how end-users perceive avatars are not fully understood, and accurately measuring these perceptions remains a challenge. To measure end-user responses more accurately to avatars, this pilot study uses a novel methodology which aims to examine and categorize end-user facial electromyography (f-EMG) responses. These responses (n = 92) can be categorized as pleasant, unpleasant, and neutral using control images sourced from the International Affective Picture System (IAPS). This methodology can also account for variability between participant responses to avatars. The novel methodology taken here can assist in the comparisons of avatars, such as gender(sex)-based differences. To examine these gender(sex) differences, participant responses to an avatar can be categorized as either pleasant, unpleasant, neutral or a combination. Although other factors such as age may unconsciously affect the participant responses, age was not directly considered in this work. This method may allow avatar developers to better understand how end-users objectively perceive an avatar. The recommendation of this methodology is to aim for an avatar that returns a pleasant, neutral, or pleasant-neutral response, unless an unpleasant response is the intended. This methodology demonstrates a novel and useful way forward to address some of the known variability issues found in f-EMG responses, and responses to avatar realism and uncanniness that can be used to examine gender(sex) perceptions.
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Ayaz O, Ismail FW. Healthcare Simulation: A Key to the Future of Medical Education - A Review. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2022; 13:301-308. [PMID: 35411198 PMCID: PMC8994530 DOI: 10.2147/amep.s353777] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/25/2022] [Indexed: 06/14/2023]
Abstract
AIM Simulation originates from its application in the military and aviation. It is implemented at various levels of healthcare education and certification today. However, its use remains unevenly distributed across the globe due to misconception regarding its cost and complexity and to lack of evidence for its consistency and validity. Implementation may also be hindered by an array of factors unique to the locale and its norms. Resource-poor settings may benefit from diverting external funds for short-term simulation projects towards collaboration with local experts and local material sourcing to reduce the overall cost and achieve long-term benefits. The recent shift of focus towards patient safety and calls for reduction in training duration have burdened educators with providing adequate quantity and quality of clinical exposure to students and residents in a short time. Furthermore, the COVID-19 pandemic has severely hindered clinical education to curb the spread of illness. Simulation may be beneficial in these circumstances and improve learner confidence. We undertook a literature search on MEDLINE using MeSH terms to obtain relevant information on simulation-based medical education and how to best apply it. Integration of simulation into curricula is an essential step of its implementation. With allocations for deliberate practice and mastery learning under supervision of qualified facilitators, this technology is becoming essential in medical education. PURPOSE To review the adaptation, spectrum of use, importance, and resource challenges of simulation in medical education and how best to implement it according to learning theories and best practice guides. CONCLUSION Simulation offers students and residents with adequate opportunities to practice their clinical skills in a risk-free environment. Unprecedented global catastrophes provide opportunities to explore simulation as a viable training tool. Future research should focus on sustainability of simulation-based medical education in LMICs.
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Affiliation(s)
- Omair Ayaz
- Aga Khan University Medical College, Karachi, Sindh, Pakistan
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Outcomes of Simulation-Based Experiences Related to Family Presence During Resuscitation: A Systematic Review. Clin Simul Nurs 2022. [DOI: 10.1016/j.ecns.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Alharbi K, Alharbi MF. Nursing Students’ Satisfaction and Self-Confidence Levels After Their Simulation Experience. SAGE Open Nurs 2022; 8:23779608221139080. [DOI: 10.1177/23779608221139080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/23/2022] [Accepted: 10/30/2022] [Indexed: 11/19/2022] Open
Abstract
Background Nursing students should be well prepared before going to clinical setting as they provide direct care to patient. Simulation gives the learners the opportunity to be active learners who practice, train, and give a reflection on a specific experience. Objective To obtain an understanding of the human patient simulation experience and nursing students’ perceptions of satisfaction and self-confidence. Method Cross-sectional, descriptive design was undertaken. Using purposive sampling, 273 nursing students were enrolled in basic adult nursing courses at levels four and five at female nursing college at King Saud University, Riyadh, Saudi Arabia. A questionnaire was used to measure the demographic characteristics, simulation design characteristics, and simulation educational practice context. Student Satisfaction and Self-confidence in Learning Scale was used to measure students’ satisfaction and self-confidence. Bivariate analyses were utilized where needed and multiple linear regression analysis was performed to find the relationship between variables. Results The current study revealed overall, nursing students were satisfied and self-confident after their human patient simulation experience. A relationship was observed between demographic characteristics, simulation design characteristics, and simulation educational practice context with students’ satisfaction and self-confidence. Conclusion Simulation is an effective teaching strategy that prepares nursing students for real clinical practice. Findings provided policymakers with information on nursing students’ current levels of satisfaction and self-confidence that can lead to developing future policies.
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Affiliation(s)
- Kholoud Alharbi
- Nursing Department, Nursing College, King Saud University, Riyadh, Saudi Arabia
| | - Manal F. Alharbi
- Maternal & Child Health Department, Nursing College, King Saud University, Riyadh, Saudi Arabia
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Brown WJ, Reid C. Implementing a cost effective and configurable hybrid simulation platform in healthcare education, using wearable and web-based technologies. SMART LEARNING ENVIRONMENTS 2022; 9:20. [PMCID: PMC9122077 DOI: 10.1186/s40561-022-00201-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/05/2022] [Indexed: 12/10/2023]
Abstract
There are many examples of hybrid simulation models in healthcare education which are designed to simulate specific scenarios. However, there appears to be a need for a cost effective and configurable hybrid simulation platform which can be used by educators of various healthcare disciplines to simulate different scenarios. The purpose of this paper is to develop a proof-of-concept platform that can be easily implemented at little cost and provide flexibility to healthcare instructors to develop a variety of simulation scenarios, and to determine the effectiveness of this platform. Using a standardized patient, a person acting as a patient in a scripted manner, along with wearable and web-based technologies, a congestive heart failure simulation was used as an evaluative exercise for a group of personal support worker students at a Canadian Community College. Personal support workers typically provide care to any person who may require personal assistance with activities of daily living such as feeding, lifting, bathing, skin care and oral hygiene to name a few. Standardized patients are typically used in healthcare education to educate and evaluate soft skills, such as caregiver to patient communication, professionalism, as well as hard skills, such as history taking, examination and diagnostic skills (Rosen in J Crit Care 23:157–166, 2008). Instructor feedback indicated that the platform was easy to use and capable of simulating a large variety of scenarios. Pre and post test results are evidence of initial findings of promise indicating that the platform seemed to be effective in enabling students to meet learning outcomes. Focus group results seem to indicate an increase in student confidence as it relates to their ability to handle a similar scenario in the workplace.
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Affiliation(s)
| | - Cindy Reid
- Georgian College of Applied Arts and Technology, Barrie, Canada
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Przedlacka A, Pellino G, Fletcher J, Bello F, Tekkis PP, Kontovounisios C. Current and future role of three-dimensional modelling technology in rectal cancer surgery: A systematic review. World J Gastrointest Surg 2021; 13:1754-1769. [PMID: 35070078 PMCID: PMC8727188 DOI: 10.4240/wjgs.v13.i12.1754] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/09/2021] [Accepted: 11/15/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Three-dimensional (3D) modelling technology translates the patient-specific anatomical information derived from two-dimensional radiological images into virtual or physical 3D models, which more closely resemble the complex environment encountered during surgery. It has been successfully applied to surgical planning and navigation, as well as surgical training and patient education in several surgical specialties, but its uptake lags behind in colorectal surgery. Rectal cancer surgery poses specific challenges due to the complex anatomy of the pelvis, which is difficult to comprehend and visualise.
AIM To review the current and emerging applications of the 3D models, both virtual and physical, in rectal cancer surgery.
METHODS Medline/PubMed, Embase and Scopus databases were searched using the keywords “rectal surgery”, “colorectal surgery”, “three-dimensional”, “3D”, “modelling”, “3D printing”, “surgical planning”, “surgical navigation”, “surgical education”, “patient education” to identify the eligible full-text studies published in English between 2001 and 2020. Reference list from each article was manually reviewed to identify additional relevant papers. The conference abstracts, animal and cadaveric studies and studies describing 3D pelvimetry or radiotherapy planning were excluded. Data were extracted from the retrieved manuscripts and summarised in a descriptive way. The manuscript was prepared and revised in accordance with PRISMA 2009 checklist.
RESULTS Sixteen studies, including 9 feasibility studies, were included in the systematic review. The studies were classified into four categories: feasibility of the use of 3D modelling technology in rectal cancer surgery, preoperative planning and intraoperative navigation, surgical education and surgical device design. Thirteen studies used virtual models, one 3D printed model and 2 both types of models. The construction of virtual and physical models depicting the normal pelvic anatomy and rectal cancer, was shown to be feasible. Within the clinical context, 3D models were used to identify vascular anomalies, for surgical planning and navigation in lateral pelvic wall lymph node dissection and in management of recurrent rectal cancer. Both physical and virtual 3D models were found to be valuable in surgical education, with a preference for 3D printed models. The main limitations of the current technology identified in the studies were related to the restrictions of the segmentation process and the lack of 3D printing materials that could mimic the soft and deformable tissues.
CONCLUSION 3D modelling technology has potential to be utilised in multiple aspects of rectal cancer surgery, however, it is still at the experimental stage of application in this setting.
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Affiliation(s)
- Anna Przedlacka
- Department of Surgery and Cancer, Imperial College London, London SW10 9NH, United Kingdom
| | - Gianluca Pellino
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, Naples 80138, Campania, Italy
- Colorectal Surgery, Vall d'Hebron University Hospital, Barcelona 08029, Spain
- Colorectal Surgery, Royal Marsden NHS Foundation Trust, London SW3 6JJ, United Kingdom
| | - Jordan Fletcher
- Department of Surgery and Cancer, St Mark’s Hospital Academic Institute, Imperial College London, London HA1 3UJ, United Kingdom
| | - Fernando Bello
- Centre for Engagement and Simulation Science, Imperial College London, London SW10 9NH, United Kingdom
| | - Paris P Tekkis
- Department of Surgery and Cancer, Imperial College London, London SW10 9NH, United Kingdom
- Colorectal Surgery, Royal Marsden NHS Foundation Trust, London SW3 6JJ, United Kingdom
- Colorectal Surgery, Chelsea and Westminster Hospital NHS Foundation Trust, London SW10 9NH, United Kingdom
| | - Christos Kontovounisios
- Department of Surgery and Cancer, Imperial College London, London SW10 9NH, United Kingdom
- Colorectal Surgery, Royal Marsden NHS Foundation Trust, London SW3 6JJ, United Kingdom
- Colorectal Surgery, Chelsea and Westminster Hospital NHS Foundation Trust, London SW10 9NH, United Kingdom
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Torres Y, Rodríguez Y, Pérez E. [How to improve the quality of healthcare services and patient safety by adopting strategies from the aviation sector?]. J Healthc Qual Res 2021; 37:182-190. [PMID: 34887228 DOI: 10.1016/j.jhqr.2021.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/26/2021] [Accepted: 10/05/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVE The World Health Organization recognizes patient safety as a priority as part of its global strategy to improve the quality of health services. However, several initiatives need to be integrated and systematized to increase the reliability of healthcare systems. This article discusses several management strategies developed in the aviation sector that have led to a drastic decrease in the accident rate. The aim is to describe each strategy and contrast them with their application in the healthcare sector. METHODS Different results and recommendations from the literature and institutions such as the World Health Organization and the International Civil Aviation Organization were consulted and compiled. A synthesis of the identified strategies was made, highlighting examples of their application and impact. RESULTS Five key strategies were identified: 1) no-blame incident reporting systems, 2) systematic use of checklists, 3) recurrent training and use of simulation, 4) management of fatigue and work schedules, and 5) management of teamwork. CONCLUSIONS The strategies from the aviation sector are presented as a valuable reference for improving patient safety and the quality of healthcare services. They should be consolidated and harmoniously integrated into the design and management of health systems.
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Affiliation(s)
- Y Torres
- Department of Mechanical Engineering, École de Technologie Supérieure, Montreal, Canadá.
| | - Y Rodríguez
- Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia
| | - E Pérez
- Facultad de Ingeniería Industrial, Universidad Pontificia Bolivariana, Medellín, Colombia
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Weaver JM. HISTORICAL SELECTION: Rosenberg MB. Simulation technology in anesthesiology. Anesth Prog. 2000;47(1):8-11. Anesth Prog 2021; 68:242-244. [PMID: 34911062 DOI: 10.2344/anpr-68-04-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Joel M Weaver
- Dentist Anesthesiologist Specialist, Professor Emeritus, College of Dentistry and Department of Anesthesiology, Wexner Medical Center, The Ohio State University, ADSA Jay A. Heidbrink Award (1998), ASDA Leonard M. Monheim Award (2003), IFDAS Horace Wells Award (2006)
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Martin A, Weller I, Amsalem D, Duvivier R, Jaarsma D, Filho MADC. Co-constructive Patient Simulation: A Learner-Centered Method to Enhance Communication and Reflection Skills. Simul Healthc 2021; 16:e129-e135. [PMID: 33273424 PMCID: PMC8169712 DOI: 10.1097/sih.0000000000000528] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION In simulation sessions using standardized patients (SPs), it is the instructors, rather than the learners, who traditionally identify learning goals. We describe co-constructive patient simulation (CCPS), an experiential method in which learners address self-identified goals. METHODS In CCPS, a designated learner creates a case script based on a challenging clinical encounter. The script is then shared with an actor who is experienced working as an SP in medical settings. An instructor with experience in the model is involved in creating, editing, and practicing role play of the case. After co-creation of the case, learners with no prior knowledge of the case (peers or a supervisor) interview the SP. The clinical encounter is followed by a group debriefing session. RESULTS We conducted 6 CCPS sessions with senior trainees in child and adolescent psychiatry. Topics that are difficult to openly talk about may be especially appropriate for the CCPS model-without overt guidance or solicitation, the scripts developed by learners for this series involved: medical errors and error disclosure; racial tensions, including overt racism; interprofessional conflict; transphobia; patient-on-provider violence; sexual health; and the sharing of vulnerability and personal imperfections in the clinical setting. CONCLUSIONS Co-constructive patient simulation provides an alternative multistage and multimodal approach to traditional SP simulation sessions that can adapt iteratively and in real time to new clinical vicissitudes and challenges This learner-centered model holds promise to enrich simulation-based education by fostering autonomous, meaningful, and relevant experiences that are in alignment with trainees' self-identified learning goals.
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Affiliation(s)
- Andrés Martin
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
- Standardized Patient Program, Teaching and Learning Center, Yale School of Medicine, New Haven, CT, USA
- Center for Educational Development and Research in Health Sciences (CEDAR), LEARN, University Medical Center Groningen, Groningen, The Netherlands
| | - Indigo Weller
- Bioethics Program, Harvard University, Cambridge, MA, USA
| | - Doron Amsalem
- Tel-Aviv University Faculty of Medicine, Ramat-Aviv, Israel
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, NY, USA
| | - Robbert Duvivier
- Center for Educational Development and Research in Health Sciences (CEDAR), LEARN, University Medical Center Groningen, Groningen, The Netherlands
- Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - Debbie Jaarsma
- Center for Educational Development and Research in Health Sciences (CEDAR), LEARN, University Medical Center Groningen, Groningen, The Netherlands
| | - Marco Antonio de Carvalho Filho
- Center for Educational Development and Research in Health Sciences (CEDAR), LEARN, University Medical Center Groningen, Groningen, The Netherlands
- School of Medical Sciences, University of Minho, Braga, Portugal
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Investigating the Effectiveness of Using a Situated Simulation-Based Program to Improve Occupational Therapy Students' Interactions and Observation Skills with Children. Occup Ther Int 2021; 2021:1698683. [PMID: 34803547 PMCID: PMC8580695 DOI: 10.1155/2021/1698683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 08/31/2021] [Accepted: 10/19/2021] [Indexed: 11/18/2022] Open
Abstract
Purpose Interaction and observation are critical skills for occupational therapists who work with pediatric clients. The objective of this study was to investigate whether using standardized child patients within a situated simulation-based (SSB) program increases students' knowledge and clinical skills when working with children in occupational therapy. Materials and Methods This controlled trial with multiple measures recruited students from the pediatric occupational therapy curriculum enrolled in an SSB program in consecutive academic years (n = 62). Experimental group students participated in a simulation experience with video training sessions, followed by an SSB exam with standardized child patients; the control group performed the video training simultaneously. Quantitative outcomes included quizzes to measure clinical knowledge, video training scores, and a situated simulation exam to assess clinical skills. Results The experimental group had a significantly higher postwritten quiz scores than the control group; the video training scores were not significantly different between groups. Linear regression analysis showed a significant association between the SSB exam and postwritten quiz scores (β = 0.487, p = 0.017). The experimental group had a total pass rate of 65.6% for the SSB exam. The communication and interaction pass rate was 53.1%; the basic evaluation rate was 68.8%, implying that communication/interaction skills are hard to simulate from video training alone; therefore, the authentic fidelity of the SSB program needs to improve further to enhance learning. Conclusions The SSB program with standardized child patients improved students' clinical knowledge and skills more than lectures and practice alone. Using standardized child patients in programs or exams appears to positively influence students' performance. Situated simulation-based learning that allows the realistic practice of observation and communication skills may enhance students' clinical competency. Future research should develop standard training methods and evaluation processes in high-fidelity simulations for generalized use in other occupational therapy programs.
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Guerreiro GP, Manuel V, Cardoso LF. The role of interdisciplinary education and practice in medicine during the COVID-19 pandemic. Int J Clin Pract 2021; 75:e14481. [PMID: 34155739 PMCID: PMC8420342 DOI: 10.1111/ijcp.14481] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 05/21/2021] [Indexed: 12/16/2022] Open
Affiliation(s)
- Gustavo Pampolha Guerreiro
- Department of Cardiovascular SurgeryInstituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor‐HCFMUSP)São PauloBrazil
| | - Valdano Manuel
- Department of Cardiovascular SurgeryInstituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor‐HCFMUSP)São PauloBrazil
| | - Lucas Figueredo Cardoso
- Department of Cardiovascular SurgeryInstituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor‐HCFMUSP)São PauloBrazil
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Sideris M, Nicolaides M, Jagiello J, Rallis KS, Emin E, Theodorou E, Hanrahan JG, Mallick R, Odejinmi F, Lymperopoulos N, Papalois A, Tsoulfas G. In vivo Simulation-Based Learning for Undergraduate Medical Students: Teaching and Assessment. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2021; 12:995-1002. [PMID: 34512069 PMCID: PMC8416184 DOI: 10.2147/amep.s272185] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 07/20/2021] [Indexed: 02/05/2023]
Abstract
An increasing emphasis on simulation has become evident in the last three decades following fundamental shifts in the medical profession. Simulation-based learning (SBL) is a wide term that encompasses several means for imitating a skill, attitude, or procedure to train personnel in a safe and adaptive environment. A classic example has been the use of live animal tissue, named in vivo SBL. We aimed to review all published evidence on in vivo SBL for undergraduate medical students; this includes both teaching concepts as well as focused assessment of students on those concepts. We performed a systematic review of published evidence on MEDLINE. We also incorporated evidence from a series of systematic reviews (eviCORE) focused on undergraduate education which have been outputs from our dedicated research network (eMERG). In vivo SBL has been shown to be valuable at undergraduate level and should be considered as a potential educational tool. Strict adherence to 3R (Reduce, Refine, Replace) principles in order to reduce animal tissue usage, should always be the basis of any curriculum. In vivo SBL could potentially grant an extra mile towards medical students' inspiration and aspiration to become safe surgeons; however, it should be optimised and supported by a well-designed curriculum which enhances learning via multi-level fidelity SBL.
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Affiliation(s)
- Michail Sideris
- Women’s Health Research Unit, Queen Mary University of London, London, UK
| | - Marios Nicolaides
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | - Kathrine S Rallis
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Elif Emin
- Women’s Health Research Unit, Queen Mary University of London, London, UK
| | - Efthymia Theodorou
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | - Rebecca Mallick
- Princess Royal Hospital, Brighton and Sussex University Hospitals NHS Trust, Haywards Heath, UK
| | - Funlayo Odejinmi
- Whipps Cross University Hospital, Barts Health NHS Trust, London, UK
| | | | - Apostolos Papalois
- Special Unit for Biomedical Research and Education, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George Tsoulfas
- Department of Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Chen T, Zhang Y, Ding C, Ting K, Yoon S, Sahak H, Hope A, McLachlin S, Crawford E, Hardisty M, Larouche J, Finkelstein J. Virtual reality as a learning tool in spinal anatomy and surgical techniques. NORTH AMERICAN SPINE SOCIETY JOURNAL 2021; 6:100063. [PMID: 35141628 PMCID: PMC8820051 DOI: 10.1016/j.xnsj.2021.100063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 02/06/2023]
Abstract
Background Surgical simulation is a valuable educational tool for trainees to practice in a safe, standardized, and controlled environment. Interactive feedback-based virtual reality (VR) has recently moved to the forefront of spine surgery training, with most commercial products focusing on instrumentation. There is a paucity of learning tools directed at decompression principles. The purpose of this study was to evaluate the efficacy of VR simulation and its educational role in learning spinal anatomy and decompressive techniques. Methods A VR simulation module was created with custom-developed software. Orthopaedic and neurosurgical trainees were prospectively enrolled and interacted with patient-specific 3D models of lumbar spinal stenosis while wearing a headset. A surgical toolkit allowed users to perform surgical decompression, specifically removing soft tissues and bone. The module allowed users to perform various techniques in posterior decompressions and comprehend anatomic areas of stenosis. Pre- and post-module testing, and utility questionnaires were administered to provide both quantitative and qualitative evaluation of the module as a learning device. Results 28 trainees were enrolled (20-orthopaedic, 8-neurosurgery) in the study. Pre-test scores on anatomic knowledge progressively improved and showed strong positive correlation with year-in-training (Pearson's r = 0.79). Following simulation, the average improvement in post-test scores was 11.4% in junior trainees (PGYI-III), and 1.0% in senior trainees (PGYIII-Fellows). Knowledge improvement approached statistical significance amongst junior trainees (p = 0.0542). 89% of participants found the VR module useful in understanding and learning the pathology of spinal stenosis. 71% found it useful in comprehending decompressive techniques. 96% believed it had utility in preoperative planning with patient-specific models. Conclusions Our original VR spinal decompression simulation has shown to be overwhelmingly positively received amongst trainees as both a learning module of patho-anatomy and patient-specific preoperative planning, with particular benefit for junior trainees.
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Affiliation(s)
- T Chen
- Department of Orthopaedic Surgery, Geisinger Medical Center, Danville, PA, United States.,Division of Spine Surgery, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
| | - Y Zhang
- Sunnybrook Research Institute, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
| | - C Ding
- Sunnybrook Research Institute, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
| | - K Ting
- Sunnybrook Research Institute, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
| | - S Yoon
- Division of Spine Surgery, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
| | - H Sahak
- Sunnybrook Research Institute, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
| | - A Hope
- Sunnybrook Research Institute, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
| | - S McLachlin
- Sunnybrook Research Institute, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
| | - E Crawford
- Division of Spine Surgery, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
| | - M Hardisty
- Sunnybrook Research Institute, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
| | - J Larouche
- Division of Spine Surgery, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
| | - J Finkelstein
- Division of Spine Surgery, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
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Abstract
Simulation-based medical education (SBME) provides experiential learning for medical trainees without any risk of harm to patients. Simulation is now included in most medical school and residency curricula. In psychiatric education, simulation programs are rapidly expanding and innovating. Major applications of SBME in psychiatry include achieving close observation of trainees with patients, preparing trainees for unstable patient scenarios, and exposing trainees to a broader range of psychopathology. This review article covers the history of SBME, simulation modalities, current use of SBME in psychiatry, a case study from one institution, and recommendations for incorporating simulation in psychiatry education.
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Affiliation(s)
- Shannon R McGue
- College of Medicine, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 812, MSC 623, Charleston, SC 29425, USA
| | - Christine M Pelic
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, MSC 861, Charleston, SC 29425, USA; Ralph H. Johnson VA Medical Center, 109 Bee Street, Charleston, SC 29401, USA
| | - Austin McCadden
- College of Medicine, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 812, MSC 623, Charleston, SC 29425, USA
| | - Christopher G Pelic
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, MSC 861, Charleston, SC 29425, USA.
| | - A Lee Lewis
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, MSC 861, Charleston, SC 29425, USA
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Khalil MK, Giannaris EL, Lee V, Baatar D, Richter S, Johansen KS, Mishall PL. Integration of clinical anatomical sciences in medical education: Design, development and implementation strategies. Clin Anat 2021; 34:785-793. [PMID: 33905130 DOI: 10.1002/ca.23736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 02/05/2021] [Accepted: 03/11/2021] [Indexed: 11/09/2022]
Abstract
For the last 20 years, undergraduate medical education has seen a major curricular reform movement toward integration of basic and clinical sciences. The rationale for integrated medical school curricula focuses on the application of knowledge in a clinical context and the early ability to practice key skills such as critical thinking and clinical problem-solving. The method and extent of discipline integration can vary widely from single sessions to entire programs. A challenge for integrated curricula is the design of appropriate assessments. The goal of this review is to provide a framework for clinical anatomy educators with definitions of integration, examples of existing integration models, strategies, and instructional methods that promote integration of basic and clinical sciences.
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Affiliation(s)
- Mohammed K Khalil
- University of South Carolina School of Medicine Greenville, Greenville, South Carolina, USA
| | | | - Vaughan Lee
- College of Medicine, University of South Alabama, Mobile, Alabama, USA
| | - Dolgor Baatar
- Kaiser Permanente School of Medicine, Pasadena, California, USA
| | - Saskia Richter
- University of Delaware, Department of Kinesiology and Applied Physiology, Newark, Delaware, USA
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Volochtchuk AVL, Leite H. Process improvement approaches in emergency departments: a review of the current knowledge. INTERNATIONAL JOURNAL OF QUALITY & RELIABILITY MANAGEMENT 2021. [DOI: 10.1108/ijqrm-09-2020-0330] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe healthcare system has been under pressure to provide timely and quality healthcare. The influx of patients in the emergency departments (EDs) is testing the capacity of the system to its limit. In order to increase EDs' capacity and performance, healthcare managers and practitioners are adopting process improvement (PI) approaches in their operations. Thus, this study aims to identify the main PI approaches implemented in EDs, as well as the benefits and barriers to implement these approaches.Design/methodology/approachThe study is based on a rigorous systematic literature review of 115 papers. Furthermore, under the lens of thematic analysis, the authors present the descriptive and prescriptive findings.FindingsThe descriptive analysis found copious information related to PI approaches implemented in EDs, such as main PIs used in EDs, type of methodological procedures applied, as well as a set of barriers and benefits. Aiming to provide an in-depth analysis and prescriptive results, the authors carried out a thematic analysis that found underlying barriers (e.g. organisational, technical and behavioural) and benefits (e.g. for patients, the organisation and processes) of PI implementation in EDs.Originality/valueThe authors contribute to knowledge by providing a comprehensive review of the main PI methodologies applied in EDs, underscoring the most prominent ones. This study goes beyond descriptive studies that identify lists of barriers and benefits, and instead the authors categorize prescriptive elements that influence these barriers and benefits. Finally, this study raises discussions about the behavioural influence of patients and medical staff on the implementation of PI approaches.
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Singh S, Bible J, Liu Z, Zhang Z, Singapogu R. Motion Smoothness Metrics for Cannulation Skill Assessment: What Factors Matter? Front Robot AI 2021; 8:625003. [PMID: 33937348 PMCID: PMC8085519 DOI: 10.3389/frobt.2021.625003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 02/09/2021] [Indexed: 12/28/2022] Open
Abstract
Medical training simulators have the potential to provide remote and automated assessment of skill vital for medical training. Consequently, there is a need to develop "smart" training devices with robust metrics that can quantify clinical skills for effective training and self-assessment. Recently, metrics that quantify motion smoothness such as log dimensionless jerk (LDLJ) and spectral arc length (SPARC) are increasingly being applied in medical simulators. However, two key questions remain about the efficacy of such metrics: how do these metrics relate to clinical skill, and how to best compute these metrics from sensor data and relate them with similar metrics? This study addresses these questions in the context of hemodialysis cannulation by enrolling 52 clinicians who performed cannulation in a simulated arteriovenous (AV) fistula. For clinical skill, results demonstrate that the objective outcome metric flash ratio (FR), developed to measure the quality of task completion, outperformed traditional skill indicator metrics (years of experience and global rating sheet scores). For computing motion smoothness metrics for skill assessment, we observed that the lowest amount of smoothing could result in unreliable metrics. Furthermore, the relative efficacy of motion smoothness metrics when compared with other process metrics in correlating with skill was similar for FR, the most accurate measure of skill. These results provide guidance for the computation and use of motion-based metrics for clinical skill assessment, including utilizing objective outcome metrics as ideal measures for quantifying skill.
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Affiliation(s)
- Simar Singh
- Department of Bioengineering, Clemson University, Clemson, SC, United States
| | - Joe Bible
- Department of Mathematical and Statistical Sciences, Clemson University, Clemson, SC, United States
| | - Zhanhe Liu
- Department of Bioengineering, Clemson University, Clemson, SC, United States
| | - Ziyang Zhang
- Department of Bioengineering, Clemson University, Clemson, SC, United States
| | - Ravikiran Singapogu
- Department of Bioengineering, Clemson University, Clemson, SC, United States
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Couarraze S, Saint-Jean M, Marhar F, Carneiro JM, Siksik G, Weider A, Kurrek MM, Rey T, Houze-Cerfon CH, LeBlanc V, Geeraerts T. Does prior exposure to clinical critical events influence stress reactions to simulation session in nursing students: A case-control study. NURSE EDUCATION TODAY 2021; 99:104792. [PMID: 33578004 DOI: 10.1016/j.nedt.2021.104792] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/09/2020] [Accepted: 01/24/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Simulation is a pedagogical method known to be a generator of stress, that could be influenced by previous stressful experiences. OBJECTIVES The purpose of this study was to determine the impact of previous experience with a clinical critical event on the stress experienced by nursing students during simulation session of critical events, and on the stress experienced during clinical critical events subsequent to the training. DESIGN Observational case-control study. SETTINGS Four critical event scenarios were created using full-scale simulation. PARTICIPANTS Two hundred and fifteen undergraduate nursing students of semester four. The control group (n = 112) consisted of learners who had not previously experienced a critical event. The prior exposure group (n = 103) consisted of learners who had experienced a critical event prior to the course. METHODS Stress levels were assessed using the self-report stress numerical rating scale-11. RESULTS There was no significant difference in the level of stress between the prior exposure group and the control group before, during or expected after the simulation session. A significant decrease in stress was observed in both groups from before the course to during the session (p < 0.05) and expected after the session (p < 0.05). There was no significant difference between the expected post-session stress level and the stress levels reported four months after the training (p = 0.966). At four months, there was no significant difference in stress levels between the groups (p = 0.212). CONCLUSIONS The prior experience of a clinical critical event before a simulation course did not influence their reported stress level during the simulation session. Conversely, simulation-based training of critical situations appears to reduce the level of self-assessed stress during critical events in clinical practice after the training.
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Affiliation(s)
- Sébastien Couarraze
- Department of Anesthesiology and Critical Care, University Hospital of Toulouse, University Toulouse 3-Paul Sabatier, Toulouse, France; Institut Toulousain de Simulation en Santé (ITSimS), University Hospital of Toulouse, University Toulouse 3-Paul Sabatier, Toulouse, France; Education Sciences, University Toulouse 2 - Jean Jaurès, Toulouse, France; Fire Department of Haute-Garonne, Toulouse, France.
| | - Michèle Saint-Jean
- Institut Toulousain de Simulation en Santé (ITSimS), University Hospital of Toulouse, University Toulouse 3-Paul Sabatier, Toulouse, France; Education Sciences, University Toulouse 2 - Jean Jaurès, Toulouse, France.
| | - Fouad Marhar
- Department of Anesthesiology and Critical Care, University Hospital of Toulouse, University Toulouse 3-Paul Sabatier, Toulouse, France; Institut Toulousain de Simulation en Santé (ITSimS), University Hospital of Toulouse, University Toulouse 3-Paul Sabatier, Toulouse, France
| | - Jean-Marc Carneiro
- Nurse School, University Hospital of Toulouse, France; Fire Department of Haute-Garonne, Toulouse, France.
| | | | - André Weider
- Care Coordinator, University Hospital of Toulouse, France.
| | - Matt M Kurrek
- Department of Anesthesiology and Critical Care, University Hospital of Toulouse, University Toulouse 3-Paul Sabatier, Toulouse, France; Institut Toulousain de Simulation en Santé (ITSimS), University Hospital of Toulouse, University Toulouse 3-Paul Sabatier, Toulouse, France; Department of Anesthesia, University of Toronto, Canada.
| | - Thierry Rey
- Nurse School, University Hospital of Toulouse, France.
| | - Charles-Henri Houze-Cerfon
- Emergency Medical Service, University Hospital of Toulouse, University Toulouse 3-Paul Sabatier, Toulouse, France; Institut Toulousain de Simulation en Santé (ITSimS), University Hospital of Toulouse, University Toulouse 3-Paul Sabatier, Toulouse, France; Education Sciences, University Toulouse 2 - Jean Jaurès, Toulouse, France.
| | - Vicki LeBlanc
- Department of Innovation in Medical Education, University of Ottawa, Ottawa, Canada.
| | - Thomas Geeraerts
- Department of Anesthesiology and Critical Care, University Hospital of Toulouse, University Toulouse 3-Paul Sabatier, Toulouse, France; Institut Toulousain de Simulation en Santé (ITSimS), University Hospital of Toulouse, University Toulouse 3-Paul Sabatier, Toulouse, France.
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Bartlett RS, Bruecker S, Eccleston B. High-Fidelity Simulation Improves Long-Term Knowledge of Clinical Swallow Evaluation. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:673-686. [PMID: 33705671 PMCID: PMC8740723 DOI: 10.1044/2020_ajslp-20-00240] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/08/2020] [Accepted: 12/08/2020] [Indexed: 06/12/2023]
Abstract
Purpose Clinical swallow evaluation (CSE) is a critical skill that speech-language pathologists who manage swallowing impairment must learn. The objective of this mixed-methods study was to determine if using a human patient simulator (HPS) to train speech-language pathology graduate students in CSE improved knowledge, preparedness, and anxiety as compared to traditional instruction alone. Method This was a controlled trial with repeated measures. Participants included graduate students from two cohorts who were enrolled in a swallowing disorders course in consecutive academic years (n = 50). Students in the experimental group participated in a simulation experience in which they performed a CSE on an HPS, generated a treatment plan, and communicated in real time with the HPS, the patient's wife, and a nurse. Quantitative results included quizzes that measured short- and long-term CSE knowledge, and qualitative findings included written feedback from instructors and students. Results Students who participated in simulation training had significantly higher long-term quiz accuracy than the control group, but their short-term quiz scores did not differ. Student ratings of preparedness and anxiety did not differ between the two groups. Many students reported that they appreciated practicing the use of patient-friendly language and preferred clinical simulation over traditional teaching methods. Facilitators reported that simulation increased student engagement and critical thinking skills more than traditional teaching methods. Conclusions CSE simulation provided objective and subjective advantages over traditional teaching methods. Recommendations from students and instructors for improving the CSE simulation training are reported.
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Yeung AWK, Tosevska A, Klager E, Eibensteiner F, Laxar D, Stoyanov J, Glisic M, Zeiner S, Kulnik ST, Crutzen R, Kimberger O, Kletecka-Pulker M, Atanasov AG, Willschke H. Virtual and Augmented Reality Applications in Medicine: Analysis of the Scientific Literature. J Med Internet Res 2021; 23:e25499. [PMID: 33565986 PMCID: PMC7904394 DOI: 10.2196/25499] [Citation(s) in RCA: 99] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/08/2020] [Accepted: 01/16/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Virtual reality (VR) and augmented reality (AR) have recently become popular research themes. However, there are no published bibliometric reports that have analyzed the corresponding scientific literature in relation to the application of these technologies in medicine. OBJECTIVE We used a bibliometric approach to identify and analyze the scientific literature on VR and AR research in medicine, revealing the popular research topics, key authors, scientific institutions, countries, and journals. We further aimed to capture and describe the themes and medical conditions most commonly investigated by VR and AR research. METHODS The Web of Science electronic database was searched to identify relevant papers on VR research in medicine. Basic publication and citation data were acquired using the "Analyze" and "Create Citation Report" functions of the database. Complete bibliographic data were exported to VOSviewer and Bibliometrix, dedicated bibliometric software packages, for further analyses. Visualization maps were generated to illustrate the recurring keywords and words mentioned in the titles and abstracts. RESULTS The analysis was based on data from 8399 papers. Major research themes were diagnostic and surgical procedures, as well as rehabilitation. Commonly studied medical conditions were pain, stroke, anxiety, depression, fear, cancer, and neurodegenerative disorders. Overall, contributions to the literature were globally distributed with heaviest contributions from the United States and United Kingdom. Studies from more clinically related research areas such as surgery, psychology, neurosciences, and rehabilitation had higher average numbers of citations than studies from computer sciences and engineering. CONCLUSIONS The conducted bibliometric analysis unequivocally reveals the versatile emerging applications of VR and AR in medicine. With the further maturation of the technology and improved accessibility in countries where VR and AR research is strong, we expect it to have a marked impact on clinical practice and in the life of patients.
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Affiliation(s)
- Andy Wai Kan Yeung
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.,Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
| | - Anela Tosevska
- Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria.,Department of Molecular, Cell and Developmental Biology, University of California Los Angeles, Los Angeles, CA, United States
| | - Elisabeth Klager
- Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
| | - Fabian Eibensteiner
- Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria.,Division of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Daniel Laxar
- Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
| | | | - Marija Glisic
- Swiss Paraplegic Research, Nottwil, Switzerland.,Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Sebastian Zeiner
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University Vienna, Vienna, Austria
| | - Stefan Tino Kulnik
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
| | - Rik Crutzen
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria.,Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Oliver Kimberger
- Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria.,Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University Vienna, Vienna, Austria
| | - Maria Kletecka-Pulker
- Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria.,Institute for Ethics and Law in Medicine, University of Vienna, Vienna, Austria
| | - Atanas G Atanasov
- Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria.,Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Jastrzebiec, Poland.,Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria.,Department of Pharmacognosy, University of Vienna, Vienna, Austria
| | - Harald Willschke
- Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria.,Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University Vienna, Vienna, Austria
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Beverly EA, Love C, Love M, Williams E, Bowditch J. Using Virtual Reality to Improve Health Care Providers' Cultural Self-Efficacy and Diabetes Attitudes: Pilot Questionnaire Study. JMIR Diabetes 2021; 6:e23708. [PMID: 33502335 PMCID: PMC7875691 DOI: 10.2196/23708] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/19/2020] [Accepted: 12/31/2020] [Indexed: 11/13/2022] Open
Abstract
Background In southeastern Appalachian Ohio, the prevalence of diabetes is 19.9%, nearly double that of the national average of 10.5%. Here, people with diabetes are more likely to have a delayed diagnosis, limited access to health care, and lower health literacy. Despite the high rates of diabetes in the region, the availability of endocrinologists and certified diabetes care and education specialists is limited. Therefore, innovative strategies to address the growing diabetes care demands are needed. One approach is to train the primary care workforce in new and emerging therapies for type 2 diabetes to meet the increasing demands and complexity of diabetes care. Objective The aim of this study was to assess the effectiveness of a virtual reality training program designed to improve cultural self-efficacy and diabetes attitudes. Methods Health care providers and administrators were recruited from large health care systems, private practices, university-owned hospitals or clinics, Federally Qualified Health Centers, local health departments, and AmeriCorps. Providers and administrators participated in a 3-hour virtual reality training program consisting of 360-degree videos produced in a professional, cinematic manner; this technique is called virtual reality cinema (cine-VR). Questionnaires measuring cultural self-efficacy, diabetes attitudes, and presence in cine-VR were administered to providers and administrators before and after the program. Results A total of 69 participants completed the study. The mean age of the sample was 42.2 years (SD 13.7), 86% (59/69) identified as female, 83% (57/69) identified as White, 86% (59/69) identified as providers, and 25% (17/69) identified as nurses. Following the training program, we observed positive improvements in all three of the cultural self-efficacy subscales: Cognitive (mean change –1.29; t65=–9.309; P<.001), Practical (mean change –1.85; t65=–9.319; P<.001), and Affective (mean change –0.75; t65=–7.067; P<.001). We observed the largest magnitude of change with the subscale, with a Cohen d of 1.16 indicating a very large effect. In addition, we observed positive improvements in all five of the diabetes attitude subscales: Need for special training (mean change –0.21; t67=–6.154; P<.001), Seriousness of type 2 diabetes (mean change –0.34; t67=–8.114; P<.001), Value of tight glucose control (mean change –0.13; t67=–3.029; P=.001), Psychosocial impact of diabetes (mean change –0.33; t67=–6.610; P<.001), and Attitude toward patient autonomy (mean change –0.17; t67=–3.889; P<.001). We observed the largest magnitude of change with the Psychosocial impact of diabetes subscale, with a Cohen d of 0.87 indicating a large effect. We observed only one significant correlation between presence in cine-VR (ie, Interface Quality) and a positive change score (ie, Affective self-efficacy) (r=.285; P=.03). Conclusions Our findings support the notion that cine-VR education is an innovative approach to improve cultural self-efficacy and diabetes attitudes among health care providers and administrators. The long-term impact of cine-VR education on cultural self-efficacy and diabetes attitudes needs to be determined.
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Affiliation(s)
- Elizabeth Ann Beverly
- Department of Primary Care, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, United States
| | - Carrie Love
- Game Research and Immersive Design Lab, J Warren McClure School of Emerging Communication Technologies, Ohio University, Athens, OH, United States
| | - Matthew Love
- Game Research and Immersive Design Lab, J Warren McClure School of Emerging Communication Technologies, Ohio University, Athens, OH, United States
| | - Eric Williams
- Game Research and Immersive Design Lab, J Warren McClure School of Emerging Communication Technologies, Ohio University, Athens, OH, United States
| | - John Bowditch
- Game Research and Immersive Design Lab, J Warren McClure School of Emerging Communication Technologies, Ohio University, Athens, OH, United States
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Kryklywy JH, Roach VA, Todd RM. Assessing the efficacy of tablet-based simulations for learning pseudo-surgical instrumentation. PLoS One 2021; 16:e0245330. [PMID: 33444407 PMCID: PMC7808648 DOI: 10.1371/journal.pone.0245330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 12/29/2020] [Indexed: 11/18/2022] Open
Abstract
Nurses and surgeons must identify and handle specialized instruments with high temporal and spatial precision. It is crucial that they are trained effectively. Traditional training methods include supervised practices and text-based study, which may expose patients to undue risk during practice procedures and lack motor/haptic training respectively. Tablet-based simulations have been proposed to mediate some of these limitations. We implemented a learning task that simulates surgical instrumentation nomenclature encountered by novice perioperative nurses. Learning was assessed following training in three distinct conditions: tablet-based simulations, text-based study, and real-world practice. Immediately following a 30-minute training period, instrument identification was performed with comparable accuracy and response times following tablet-based versus text-based training, with both being inferior to real-world practice. Following a week without practice, response times were equivalent between real-world and tablet-based practice. While tablet-based training does not achieve equivalent results in instrument identification accuracy as real-world practice, more practice repetitions in simulated environments may help reduce performance decline. This project has established a technological framework to assess how we can implement simulated educational environments in a maximally beneficial manner.
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Affiliation(s)
- James H. Kryklywy
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Victoria A. Roach
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, Michigan, United States of America
- Department of Surgery, Oakland University William Beaumont School of Medicine, Rochester, Michigan, United States of America
| | - Rebecca M. Todd
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
- Dajvad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
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Simulation in Social Work: Creativity of Students and Faculty during COVID-19. SOCIAL SCIENCES-BASEL 2021. [DOI: 10.3390/socsci10010007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Simulation learning plays an important role in social work education, allowing students to explore how theory and practice parameters can be integrated into actual situations they are likely to experience in the field. The arrival of COVID-19 and the sudden cessation of in-field practicum opportunities raised challenges for students to gain needed practice experience. Simulation offers an opportunity to enhance learning in place of some direct experience when that is not available. This paper reports on a simulation development practicum, where students, not able to be in an agency, sought out ways to achieve learning through the development and implementation of simulation learning. This was combined with a literature review. Results showed that student-generated simulation could be used to support direct practice learning. This project also illustrated that social work simulation can be used to help students safely explore areas of practice that they may not be exposed to in practicum through scenarios that cause them to examine how to work with clients where cross-cultural needs exist, and challenge ethical dilemmas in a ‘real-world’ situation while being required to face their biases.
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Doozandeh P. From surface realism to training considerations: a proposal for changing the focus in the design of training systems. THEORETICAL ISSUES IN ERGONOMICS SCIENCE 2020. [DOI: 10.1080/1463922x.2020.1849442] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Pooyan Doozandeh
- College of Information Sciences and Technology, The Pennsylvania State University, University Park, PA, USA
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Raju B, Jumah F, Narayan V, Sonig A, Sun H, Nanda A. The mediums of dissemination of knowledge and illustration in neurosurgery: unraveling the evolution. J Neurosurg 2020; 135:955-961. [PMID: 33276342 DOI: 10.3171/2020.7.jns201053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 07/06/2020] [Indexed: 11/06/2022]
Abstract
The earliest evidence of man's attempts in communicating ideas and emotions can be seen on cave walls and ceilings from the prehistoric era. Ingenuity, as well as the development of tools, allowed clay tablets to become the preferred method of documentation, then papyrus and eventually the codex. As civilizations advanced to develop structured systems of writing, knowledge became a power available to only those who were literate. As the search to understand the intricacies of the human brain moved forward, so did the demand for teaching the next generation of physicians. The different methods of distributing information were forced to advance, lest the civilization falls behind. Here, the authors present a historical perspective on the evolution of the mediums of illustration and knowledge dissemination through the lens of neurosurgery. They highlight how the medium of choice transitioned from primitive clay pots to cutting-edge virtual reality technology, aiding in the propagation of medical literature from generation to generation across the centuries.
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Affiliation(s)
- Bharath Raju
- 1Department of Neurosurgery, Rutgers-Robert Wood Johnson Medical School and University Hospital, New Brunswick, New Jersey; and
| | - Fareed Jumah
- 1Department of Neurosurgery, Rutgers-Robert Wood Johnson Medical School and University Hospital, New Brunswick, New Jersey; and
| | - Vinayak Narayan
- 1Department of Neurosurgery, Rutgers-Robert Wood Johnson Medical School and University Hospital, New Brunswick, New Jersey; and
| | | | - Hai Sun
- 1Department of Neurosurgery, Rutgers-Robert Wood Johnson Medical School and University Hospital, New Brunswick, New Jersey; and
| | - Anil Nanda
- 1Department of Neurosurgery, Rutgers-Robert Wood Johnson Medical School and University Hospital, New Brunswick, New Jersey; and
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Senbekov M, Saliev T, Bukeyeva Z, Almabayeva A, Zhanaliyeva M, Aitenova N, Toishibekov Y, Fakhradiyev I. The Recent Progress and Applications of Digital Technologies in Healthcare: A Review. Int J Telemed Appl 2020; 2020:8830200. [PMID: 33343657 PMCID: PMC7732404 DOI: 10.1155/2020/8830200] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 11/16/2020] [Accepted: 11/17/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The implementation of medical digital technologies can provide better accessibility and flexibility of healthcare for the public. It encompasses the availability of open information on the health, treatment, complications, and recent progress on biomedical research. At present, even in low-income countries, diagnostic and medical services are becoming more accessible and available. However, many issues related to digital health technologies remain unmet, including the reliability, safety, testing, and ethical aspects. PURPOSE The aim of the review is to discuss and analyze the recent progress on the application of big data, artificial intelligence, telemedicine, block-chain platforms, smart devices in healthcare, and medical education. Basic Design. The publication search was carried out using Google Scholar, PubMed, Web of Sciences, Medline, Wiley Online Library, and CrossRef databases. The review highlights the applications of artificial intelligence, "big data," telemedicine and block-chain technologies, and smart devices (internet of things) for solving the real problems in healthcare and medical education. Major Findings. We identified 252 papers related to the digital health area. However, the number of papers discussed in the review was limited to 152 due to the exclusion criteria. The literature search demonstrated that digital health technologies became highly sought due to recent pandemics, including COVID-19. The disastrous dissemination of COVID-19 through all continents triggered the need for fast and effective solutions to localize, manage, and treat the viral infection. In this regard, the use of telemedicine and other e-health technologies might help to lessen the pressure on healthcare systems. Summary. Digital platforms can help optimize diagnosis, consulting, and treatment of patients. However, due to the lack of official regulations and recommendations, the stakeholders, including private and governmental organizations, are facing the problem with adequate validation and approbation of novel digital health technologies. In this regard, proper scientific research is required before a digital product is deployed for the healthcare sector.
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Affiliation(s)
- Maksut Senbekov
- S.D. Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Timur Saliev
- S.D. Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | | | | | | | - Nazym Aitenova
- NJSC “Astana Medical University”, Nur-Sultan, Kazakhstan
| | | | - Ildar Fakhradiyev
- S.D. Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
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Pawłowicz E, Kulesza M, Szymańska A, Masajtis-Zagajewska A, Bartczak M, Nowicki M. 'I hear and I forget. I see and I remember. I do and I understand.'- incorporating high-fidelity medical simulation into the undergraduate nephrology course. Ren Fail 2020; 42:1184-1191. [PMID: 33243066 PMCID: PMC7717839 DOI: 10.1080/0886022x.2020.1847722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Medical simulation is a teaching method, which enables the development of clinical skills by implementing a simulation scenario in a true-to-life environment, but without exposing patients to any risk. So far, there has been no information on the use of high-fidelity simulation in undergraduate clinical nephrology teaching. Aim of this study was to analyze students' opinions and reactions to the simulation module in nephrology. Methods The survey consisting of the Satisfaction with Simulation Experience Scale (SSES) and open-ended question concerning the overall impression of classes was conducted among 103 5th year medical students, who took part in the simulation training in nephrology. SSES consisted of three parts (debriefing, reasoning, education). Statements from the open-ended question were interpreted by means of the Atlas.ti software for qualitative data analysis. Results The overall score for simulation classes was 4.39 ± 0.69 points. Students rated debriefing, reasoning and education at 4.43 ± 0.78, 4.32 ± 0.7 and 4.39 ± 0.73 points, respectively. 87.4% and 84.5% of participants agreed that simulation developed their 'clinical reasoning' and 'decision-making' skills in nephrology, respectively. Thematic analysis revealed that students evaluated the module as 'interesting', 'useful' and 'informative', but they found number of classes significantly insufficient. Students pointed out that due to the small emphasis placed on practical aspects in the existing curriculum e.g. routes of drug administration and conversion of doses, they could not fully benefit from simulation. Conclusion Medical simulation is a valuable constituent of the nephrology course. Putting greater emphasis on practical aspects from the beginning of training may enable students to benefit more from simulation modules.
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Affiliation(s)
- Ewa Pawłowicz
- Department of Nephrology, Hypertension and Kidney Transplantation, Medical University of Lodz, Lodz, Poland
| | - Michelle Kulesza
- Department of Nephrology, Hypertension and Kidney Transplantation, Medical University of Lodz, Lodz, Poland
| | - Aleksandra Szymańska
- Department of Nephrology, Hypertension and Kidney Transplantation, Medical University of Lodz, Lodz, Poland
| | - Anna Masajtis-Zagajewska
- Department of Nephrology, Hypertension and Kidney Transplantation, Medical University of Lodz, Lodz, Poland
| | - Maria Bartczak
- Medical Simulation Center, Medical University of Lodz, Lodz, Poland
| | - Michał Nowicki
- Department of Nephrology, Hypertension and Kidney Transplantation, Medical University of Lodz, Lodz, Poland
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Computer based simulation in CT and MRI radiography education: Current role and future opportunities. Radiography (Lond) 2020; 27:733-739. [PMID: 33243566 DOI: 10.1016/j.radi.2020.11.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/06/2020] [Accepted: 11/12/2020] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The use of Computer-based simulation (CBS), a form of simulation which utilises digital and web based platforms, is widely acknowledged in healthcare education. This literature review explores the current evidence relating to CBS activities in supporting radiographer education in CT and MRI. KEY FINDINGS Journal articles published between 2010 and 2020 were reviewed (n = 663). The content was evaluated and summarised with the following headings; current utility, overview of CBS types, knowledge acquisition and evaluation, and student perspective. CBS utility in CT and MRI radiography education is limited. Its current use is for pre-registration education, and the interfaces used vary in design but are predominantly used as a preclinical learning tool to support the training of geometric scan planning, image acquisition and reconstruction, and associated technical skills. CBS was positively acknowledged by student radiographers; based on its inherent flexibility, self-paced learning and the ability to practice in a safe environment. Nonetheless, the educational validation of CBS in CT and MRI education pertaining to knowledge and skill acquisition has not been fully assessed through rigorous academic assessments and metrics. CONCLUSION The current use of CBS in CT and MRI education is limited. The development of software programmes with functionality and capability that correlates with current clinical practice is imperative; and to enable more research in CBS utility to be undertaken to establish the efficacy of this pedagogical approach. IMPLICATIONS FOR PRACTICE Due to limited placement opportunities, the use of simulation is increasing and evolving; in line with the approach to design and deliver high quality Simulation Based Education (SBE) in Diagnostic Radiography education. The continued development, utility and evaluation of CBS interfaces to support student radiographers at pre and post registration level is therefore essential.
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